Individual provider Active NPI

Dolores Sudds, PHARMACIST

  • Pharmacist
  • Las Vegas, NV
National Provider Identifier
1700480647
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
09185 Issued in NV
Practice address
1910 E Serene Ave
Las Vegas, NV 89123-3218
Phone
(702) 614-3387
NPI assigned
Nov 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 09185 NV Primary

Addresses

Primary practice location

1910 E Serene Ave
Las Vegas, NV 89123-3218

Mailing address

1910 E Serene Ave
Las Vegas, NV 89123-3218
Phone (702) 614-3387

Other identifiers 1

IdentifierTypeStateIssuer
09185OtherNVPHARMACIST LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09185NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1700480647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 E SERENE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233218",
            "telephone_number": "702-614-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E SERENE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233218",
            "telephone_number": "702-614-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDS",
        "first_name": "DOLORES",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "09185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "09185",
            "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 Nov 22, 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.