Mahendra Defonseka, MD, CHTD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

NV3983 Issued in NV

Legal business name

MAHENDRA DEFONSEKA, MD, CHTD

Practice address

98 E Lake Mead Pkwy
Suite 302
Henderson, NV 89015-5540

Phone

(702) 565-3037

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Mahendra Defonseka, M.D.

Title

Owner

Phone

(702) 565-3037

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1700838042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174439",
            "telephone_number": "702-967-2352",
            "fax_number": "702-967-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E LAKE MEAD PKWY",
            "address_2": "SUITE 302",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890155540",
            "telephone_number": "702-565-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHENDRA DEFONSEKA, MD, CHTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "DEFONSEKA",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-565-3037",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NV",
            "license": "NV3983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002002520",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV3383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Lynn Maglalang, M.S. CCC-SLP
• Magnolia Counseling LLC (Magnolia Counseling)
• Mahender K Gaba, a Professional Corporation
• Devendranath Mahender Nath, R.PH.
• Ajeet Mahendernath, MD
• Mahgerefteh Medical PLLC
• Babak Mahgerefteh, D.O.
• David L Mahon, DDS
• Ryan Andrew Mai
• Mary L Maico, OTD, OTR/L

• Gastroenterology Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Gastroenterology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.