Active NPI
Marivic De Leon, DMD, MPH
- Pediatric Dentistry
- Las Vegas, NV
National Provider Identifier
1588337489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- S6-234
- Practice address
- 3600 N Buffalo Dr
Las Vegas, NV 89129-7463 - Phone
- (702) 254-8858
- NPI assigned
- Jul 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | S6-234 | NV | Primary |
Addresses
Primary practice location
3600 N Buffalo Dr
Las Vegas, NV 89129-7463
Mailing address
3600 N Buffalo Dr Ste 110
Las Vegas, NV 89129-7462
Phone (702) 254-8858
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
| License | State | Type | Specialty |
|---|---|---|---|
| S6-234 | NV | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1588337489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 N BUFFALO DR STE 110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891297462",
"telephone_number": "702-254-8858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 N BUFFALO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891297463",
"telephone_number": "702-254-8858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "MARIVIC",
"name_prefix": "Dr.",
"credential": "DMD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-27",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NV",
"license": "S6-234",
"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 Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.