Individual provider Active NPI

Chao Suo

  • Dentist
  • North Las Vegas, NV
National Provider Identifier
1639736259
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7221 Issued in NV
Practice address
640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514
Phone
(702) 399-3800
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7221 NV Primary

Addresses

Primary practice location

640 E Deer Springs Way Ste 180
North Las Vegas, NV 89086-1514

Mailing address

7401 W Washington Ave Apt 1114
Las Vegas, NV 89128-4310
Phone (605) 202-9045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20191213000035 NC Order and Referring Only - DentistPractitioner - Dentist 6103155080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7221NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shahrestani Deer Springs Modern Dentistry, PC Dentist Past Accepting new patients

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1639736259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 W WASHINGTON AVE APT 1114",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891284310",
            "telephone_number": "605-202-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E DEER SPRINGS WAY STE 180",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861514",
            "telephone_number": "702-399-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUO",
        "first_name": "CHAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.