NPIMap

Organization Active NPI

Board of Regents, Nevada System of Higher Education

  • Dental Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1487680815
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION
Practice address
1707 W. Charleston Blvd.
Suite 210
Las Vegas, NV 89102-2351
Phone
(702) 671-5175
Fax
(702) 474-9617
NPI assigned
Jun 25, 2006
Last updated
Mar 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
BOARD OF REGENTS, NV SYSTEM OF HIGHER EDUCATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Mrs. Laurie Ann Evans, MBA
Title
Director of Clinical Business SVCS.
Phone
(702) 774-2819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1707 W. Charleston Blvd.
Suite 210
Las Vegas, NV 89102-2351

Mailing address

1001 Shadow Lane
Ms 7413
Las Vegas, NV 89106-4124
Phone (702) 774-2400

Other identifiers 1

IdentifierTypeStateIssuer
002202240MedicaidNV

Other names 1

  • UNLV General Practice Residency Other name

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents Nevada26 organizations share this tax ID, including this one
Part of
Board of Regents Nevada

Other organizations with this tax ID 25

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

View all 25

Locations

1707 W Charleston Blvd
Ste 210
Las Vegas, NV 89102
Phone (702) 671-5175

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1487680815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LANE",
            "address_2": "MS 7413",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-2400",
            "fax_number": "702-774-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W. CHARLESTON BLVD.",
            "address_2": "SUITE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022351",
            "telephone_number": "702-671-5175",
            "fax_number": "702-474-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOARD OF REGENTS, NV SYSTEM OF HIGHER EDUCATION",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL BUSINESS SVCS.",
        "authorized_official_telephone_number": "702-774-2819",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002202240",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNLV General Practice Residency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 28, 2014; 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.