Las Vegas Oral Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S2-26 Issued in NV

Legal business name

LAS VEGAS ORAL SURGERY INC

Practice address

7670 W Lake Mead Blvd
Suite 130
Las Vegas, NV 89128-6649

Phone

(702) 312-2273

Fax

(702) 312-2276

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Kevin M Martin, DDS

Title

Owner

Phone

(702) 204-8862

Specialties & licenses 1

Addresses

Other names 1

• Las Vegas Oral Surgery Doing business as

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1487828356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7670 W LAKE MEAD BLVD",
            "address_2": "SUITE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286649",
            "telephone_number": "702-312-2273",
            "fax_number": "702-312-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7670 W LAKE MEAD BLVD",
            "address_2": "SUITE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286649",
            "telephone_number": "702-312-2273",
            "fax_number": "702-312-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS ORAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-204-8862",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Vegas Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.