NPIMap

Organization Active NPI

Marina Hills Dental, LLC

  • Dental Clinic/Center
  • Spring Creek, NV
National Provider Identifier
1629420419
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6673 Issued in NV
Legal business name
MARINA HILLS DENTAL, LLC
Practice address
282 Spring Creek Pkwy
Ste. 202
Spring Creek, NV 89815-5822
Phone
(775) 738-3110
Fax
(775) 738-3114
NPI assigned
Jul 6, 2016
Last updated
Jul 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Authorized official

Name
Robert Petersen, DDS
Title
Owner/Dentist
Phone
(775) 738-3110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6673 NV Primary

Addresses

Primary practice location

282 Spring Creek Pkwy
Ste. 202
Spring Creek, NV 89815-5822

Mailing address

282 Spring Creek Pkwy
Ste. 202
Spring Creek, NV 89815-5822
Phone (775) 738-3110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1629420419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 SPRING CREEK PKWY",
            "address_2": "STE. 202",
            "city": "SPRING CREEK",
            "state": "NV",
            "postal_code": "898155822",
            "telephone_number": "775-738-3110",
            "fax_number": "775-738-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 SPRING CREEK PKWY",
            "address_2": "STE. 202",
            "city": "SPRING CREEK",
            "state": "NV",
            "postal_code": "898155822",
            "telephone_number": "775-738-3110",
            "fax_number": "775-738-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA HILLS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "775-738-3110",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NV",
            "license": "6673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Creek, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.