Individual provider Active NPI

William R Hyman, DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • North Las Vegas, NV
National Provider Identifier
1700076601
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
S3-373C Issued in NV
Practice address
3896 N Martin Luther King Blvd
North Las Vegas, NV 89032
Phone
(702) 614-1792
NPI assigned
Jul 26, 2007
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 33781 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X S3-373C NV Primary

Addresses

Primary practice location

3896 N Martin Luther King Blvd
North Las Vegas, NV 89032

Mailing address

15 Boulderback Dr
Henderson, NV 89012-7286
Phone (323) 401-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231024002796 CA Order and Referring Only - DentistPractitioner - Dentist 1557717741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
33781CAMDPsychologist
S3-373CNVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
William R Hyman Dental Practice, Inc. Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Lee MLK Dental Group, PC PastSince Jun 25, 2023 Accepting new patients

Locations

3533 W Beverly Blvd
Montebello, CA 90640
Phone (323) 726-8300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1700076601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BOULDERBACK DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890127286",
            "telephone_number": "323-401-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 N MARTIN LUTHER KING BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-614-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYMAN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "33781",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3-373C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.