NPIMap

Organization Active NPI

Modern Dental Specialist, LLC

Doing business as Modern Dental

  • Endodontics
  • Las Vegas, NV
National Provider Identifier
1487344032
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
MODERN DENTAL SPECIALIST, LLC
Doing business as
Modern Dental
Modern Dental Specialists
Practice address
2560 S Maryland Pkwy Ste 5&6
Las Vegas, NV 89109-1695
Phone
(702) 200-9000
NPI assigned
May 8, 2023
Last updated
May 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MODERN DENTAL SPECIALISTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Anastasia Savcic
Title
HR
Phone
(702) 449-2643

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU Primary
Periodontics 1223P0300X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

2560 S Maryland Pkwy Ste 5&6
Las Vegas, NV 89109-1695

Mailing address

4618 Meadows LN
Las Vegas, NV 89107-2956
Phone (702) 623-3200

Other names 2

  • Modern Dental Doing business as
  • Modern Dental Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Dental Specialist LLC7 organizations share this tax ID, including this one
Part of
Modern Dental Specialist LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2560 S Maryland Pkwy
Ste 56
Las Vegas, NV 89109
Phone (702) 200-9000

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1487344032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 MEADOWS LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072956",
            "telephone_number": "702-623-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 S MARYLAND PKWY STE 5&6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091695",
            "telephone_number": "702-200-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL SPECIALIST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODERN DENTAL SPECIALISTS, LLC",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "SAVCIC",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "702-449-2643"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.