Organization Active NPI

Desert Bloom Pediatrics, PLLC

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1629997903
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
DESERT BLOOM PEDIATRICS, PLLC
Practice address
8352 W Warm Springs Rd Ste 210
Las Vegas, NV 89113-3630
Phone
(702) 551-1765
NPI assigned
Jul 13, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Holly Gavin
Title
Ceo
Phone
(702) 551-1765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

8352 W Warm Springs Rd Ste 210
Las Vegas, NV 89113-3630

Mailing address

PO Box 44231
Belfast, ME 04915-1294
Phone (702) 551-1765

National Provider Directory

National Provider Directory

Locations

801 S Rancho Dr
Ste C1
Las Vegas, NV 89106
Phone (702) 436-1364

NPI Registry JSON

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1629997903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44231",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151294",
            "telephone_number": "702-551-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8352 W WARM SPRINGS RD STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133630",
            "telephone_number": "702-551-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT BLOOM PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-551-1765"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 6, 2026; 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.