Individual provider Active NPI

Alan Estrada, DMD

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1629788690
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7722 Issued in NV
Practice address
2570 Wigwam Pkwy Ste 110
Henderson, NV 89074-6225
Phone
(702) 757-3399
NPI assigned
Dec 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7722 NV Primary

Addresses

Primary practice location

2570 Wigwam Pkwy Ste 110
Henderson, NV 89074-6225

Mailing address

2570 Wigwam Pkwy Ste 110
Henderson, NV 89074-6225
Phone (702) 757-3399

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alan.estrada@pacden.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118003189 CA Order and Referring Only - DentistPractitioner - Dentist 0446621072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Velayo Green Valley Smiles Dentistry, PC General Practice CurrentSince Dec 6, 2022 Accepting new patients

Locations

2570 Wigwam Pkwy
Ste 110
Henderson, NV 89074
Phone (702) 757-3399

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1629788690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 WIGWAM PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746225",
            "telephone_number": "702-757-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 WIGWAM PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746225",
            "telephone_number": "702-757-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alan.estrada@pacden.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2570 Wigwam Pkwy Ste 110",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890746225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.