Jorge A. Vernon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4582T Issued in NV

Practice address

3945 S Maryland Pkwy
Ste. #a
Las Vegas, NV 89119-7562

Phone

(702) 735-3838

Fax

(702) 735-3880

NPI assigned

Mar 5, 2008

Last updated

Aug 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1447420476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR",
            "address_2": "STE. 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064043",
            "telephone_number": "702-291-2031",
            "fax_number": "702-366-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 S MARYLAND PKWY",
            "address_2": "STE. #A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197562",
            "telephone_number": "702-735-3838",
            "fax_number": "702-735-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "JORGE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4582T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447420476",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Vernik, MD
• Cielo M Vernon
• Edie Vernon
• Jade Vernon, LPN
• Jennifer Vernon, RN
• Tiana Marie Vernooy
• Leosmanuel Verona Inguanzo
• Liesy Verona
• Theresa Versa
• Devone Verse III

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.