Organization Active NPI

Harmon and Otteson Dental Decatur LLC

Doing business as Reflection Dental

  • Dental Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1629813241
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HARMON AND OTTESON DENTAL DECATUR LLC
Doing business as
Reflection Dental
Practice address
4001 S Decatur Blvd Ste 42
Las Vegas, NV 89103-5860
Phone
(702) 825-6887
NPI assigned
Jun 26, 2024
Last updated
Jun 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Authorized official

Name
Kendra Ebert
Title
Coo
Phone
(765) 669-1254

Specialties & licenses 1

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

Addresses

Primary practice location

4001 S Decatur Blvd Ste 42
Las Vegas, NV 89103-5860

Mailing address

8217 Swan Lake Ave
Las Vegas, NV 89128-7411
Phone (765) 669-1254

Other names 1

  • Reflection Dental Doing business as

National Provider Directory

National Provider Directory

Locations

4001 S Decatur Blvd
Ste 42
Las Vegas, NV 89103
Phone (702) 825-6887

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1629813241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8217 SWAN LAKE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287411",
            "telephone_number": "765-669-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 S DECATUR BLVD STE 42",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035860",
            "telephone_number": "702-825-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARMON AND OTTESON DENTAL DECATUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "765-669-1254"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reflection Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 26, 2024; 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.