Individual provider Active NPI

Jorge Jimenez-Marquez, DMD

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1639529704
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6794 Issued in NV
Practice address
7545 W Sahara Ave
Suite 200
Las Vegas, NV 89117-2866
Phone
(702) 838-0707
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6794 NV Primary

Addresses

Primary practice location

7545 W Sahara Ave
Suite 200
Las Vegas, NV 89117-2866

Mailing address

122 Bella Milano Ave
Las Vegas, NV 89183-5538
Phone (702) 203-2961

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830001162 NV Practitioner - Oral SurgeryPractitioner - Dentist 6608315908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jorge Jimenez-Marquez, DMD, PLLC CurrentSince Jun 17, 2024 Accepting new patients
Kim-Vy C Pham DMD PLLC CurrentSince Jun 17, 2024 Accepting new patients

Locations

110 E Bruner Ave
Ste 130
Las Vegas, NV 89183
Phone (702) 798-6684

3663 E Sunset Rd
Ste 301
Las Vegas, NV 89120
Phone (702) 450-5999

Organizations & group practices 2

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1639529704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BELLA MILANO AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835538",
            "telephone_number": "702-203-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 W SAHARA AVE",
            "address_2": "SUITE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172866",
            "telephone_number": "702-838-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ-MARQUEZ",
        "first_name": "JORGE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.