Individual provider Active NPI

Summer Lane

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
National Provider Identifier
1558761585
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
S2-180 Issued in NV
Practice address
6780 S Fort Apache Rd Ste 108
Las Vegas, NV 89148-5405
Phone
(725) 235-9301
NPI assigned
Aug 27, 2014
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS-041228 PA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X S2-180 NV Primary

Addresses

Primary practice location

6780 S Fort Apache Rd Ste 108
Las Vegas, NV 89148-5405

Mailing address

7221 Harlow St
Las Vegas, NV 89131-2332
Phone (415) 990-1052

Other practice location 1

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (415) 990-1052

Other practice location 2

3016 W Charleston Blvd
Las Vegas, NV 89102-1977
Phone (702) 723-0274

Other practice location 3

653 N Stephanie St # C3
Henderson, NV 89014-2634
Phone (702) 723-0274

Other practice location 4

3041 E Flamingo Rd # Cd
Las Vegas, NV 89121-7446
Phone (702) 723-0274

Other practice location 5

4451 N Rancho Dr
Las Vegas, NV 89130-3405
Phone (702) 723-0274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS-041228PAMDDentist
S2-180NVMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1558761585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7221 HARLOW ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312332",
            "telephone_number": "415-990-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 S FORT APACHE RD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485405",
            "telephone_number": "725-235-9301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124756",
            "country_code": "US",
            "telephone_number": "415-990-1052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3016 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021977",
            "country_code": "US",
            "telephone_number": "702-723-0274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "653 N Stephanie St # C3",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890142634",
            "country_code": "US",
            "telephone_number": "702-723-0274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3041 E Flamingo Rd # Cd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891217446",
            "country_code": "US",
            "telephone_number": "702-723-0274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4451 N Rancho Dr",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891303405",
            "country_code": "US",
            "telephone_number": "702-723-0274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "SUMMER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS-041228",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 10, 2022; 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.