Dominique Smith, PHLEBOTOMIST

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

57346-AL-O Issued in NV

Practice address

1701 N Green Valley Pkwy Ste 9a
Henderson, NV 89074-5991

Phone

(702) 407-1100

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1669027843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 W CHARLESTON BLVD APT 1041",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177051",
            "telephone_number": "702-758-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY STE 9A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745991",
            "telephone_number": "702-407-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9225 W Charleston Blvd Apt 1041",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891177051",
            "country_code": "US",
            "telephone_number": "702-758-2817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOMINIQUE",
        "name_prefix": "Mrs.",
        "credential": "PHLEBOTOMIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NV",
            "license": "57346-AL-O",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David P Smith, O.D.
• Deirdre Smith
• Denise Smith
• Dinita Smith, MSW, LCADC
• Dionisha Smith
• Fabulous Smith
• Harvey P Smith Jr., PA
• Heather Smith
• Jackalynn Therese Smith, FNP-BC
• James E. Smith, PH.D.

• Phlebotomy Technician in Henderson, NV
• Providers in Henderson, NV by specialty
• Phlebotomy Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.