Icon Cosmetic Center LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

ICON COSMETIC CENTER LLC

Practice address

8930 W Sunset Rd Ste 140
Las Vegas, NV 89148-5009

Phone

(702) 703-3040

NPI assigned

Sep 21, 2021

Organization subpart

No

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

Authorized official

Name

Adahlia Alcova

Title

General Manager

Phone

(702) 964-4779

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1609547686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 W SUNSET RD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485009",
            "telephone_number": "702-703-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 W SUNSET RD STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485009",
            "telephone_number": "702-703-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON COSMETIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "ALCOVA",
        "authorized_official_first_name": "ADAHLIA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "702-964-4779"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Plastic and Reconstructive Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.