Active NPI
Aida Flavia Cappiello, D.D.S.
- General Practice Dentistry
- Las Vegas, NV
National Provider Identifier
1639217466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4883T
- Practice address
- 169 N Nellis Blvd
Las Vegas, NV 89110-5320 - Phone
- (702) 384-1010
- Fax
- (702) 438-8424
- NPI assigned
- Feb 2, 2007
- Last updated
- Aug 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4883T | NV | Primary |
Addresses
Primary practice location
169 N Nellis Blvd
Las Vegas, NV 89110-5320
Mailing address
526 S Tonopah Dr
Ste. 200
Las Vegas, NV 89106-4043
Phone (702) 291-2031
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639217466 | Medicaid | NV | |
| 100510643DENTIST | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161010001323 | NV | Order and Referring Only - Other (Non-Physician) | 2961790886 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4883T | NV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1639217466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 S TONOPAH DR",
"address_2": "STE. 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064043",
"telephone_number": "702-291-2031",
"fax_number": "702-366-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 N NELLIS BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891105320",
"telephone_number": "702-384-1010",
"fax_number": "702-438-8424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPPIELLO",
"first_name": "AIDA",
"middle_name": "FLAVIA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "4883T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639217466",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100510643DENTIST",
"state": "NV"
}
],
"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 Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.