Endalkachew Mersha D.M.D,a Professional Corpation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3362 Issued in NV

Legal business name

ENDALKACHEW MERSHA D.M.D,A PROFESSIONAL CORPATION

Doing business as

Discovery Dental

Practice address

2350 S Jones Blvd Ste 120
Las Vegas, NV 89146-3124

Phone

(702) 889-2624

Fax

(702) 889-6131

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

William Orellana

Title

Office MGR

Phone

(702) 889-5000

Specialties & licenses 1

Addresses

Other names 1

• Discovery Dental Doing business as

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1609095561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 S JONES BLVD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463124",
            "telephone_number": "702-889-2624",
            "fax_number": "702-889-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S JONES BLVD STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463124",
            "telephone_number": "702-889-2624",
            "fax_number": "702-889-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDALKACHEW MERSHA D.M.D,A PROFESSIONAL CORPATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "ORELLANA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "702-889-5000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Discovery Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.