Individual provider Active NPI

Natalie Djansezian

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1568056216
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7843 Issued in NV
Practice address
1700 W Charleston Blvd # Ms 7424
Las Vegas, NV 89102-2335
Phone
(702) 774-5175
Fax
(702) 774-2812
NPI assigned
Feb 23, 2021
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X LL-552-21 NV
General Practice Dentistry 1223G0001X 7843 NV Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1700 W Charleston Blvd # Ms 7424
Las Vegas, NV 89102-2335

Mailing address

1700 W Charleston Blvd # Ms 7424
Las Vegas, NV 89102-2335
Phone (702) 774-5175

Other practice location 1

9895 S Maryland Pkwy Ste A
Las Vegas, NV 89483-2335
Phone (702) 372-4039

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
7843NVMDGeneral Practice Dentistry
LL-552-21NVMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: mrice109451@direct.umcsn.com

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1568056216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W CHARLESTON BLVD # MS 7424",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022335",
            "telephone_number": "702-774-5175",
            "fax_number": "702-774-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W CHARLESTON BLVD # MS 7424",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022335",
            "telephone_number": "702-774-5175",
            "fax_number": "702-774-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9895 S Maryland Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "894832335",
            "country_code": "US",
            "telephone_number": "702-372-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DJANSEZIAN",
        "first_name": "NATALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "LL-552-21",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7843",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 11, 2024; 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.