Individual provider Active NPI

Yadiel Kinfu

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1720440589
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7208 Issued in NV
Practice address
8445 W Flamingo Rd
Las Vegas, NV 89147-4166
Phone
(702) 309-0909
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7208 NV Primary

Addresses

Primary practice location

8445 W Flamingo Rd
Las Vegas, NV 89147-4166

Mailing address

8445 W Flamingo Rd
Las Vegas, NV 89147-4166
Phone (702) 309-0909

Other practice location 1

2002 Holcombe Boulevard
713-794-7187
Houston, TX 77030
Phone (713) 794-7187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20190911003701 NV Order and Referring Only - DentistPractitioner - Dentist 2365771656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7208NVMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1720440589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8445 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891474166",
            "telephone_number": "702-309-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891474166",
            "telephone_number": "702-309-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 Holcombe Boulevard",
            "address_2": "713-794-7187",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "713-794-7187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINFU",
        "first_name": "YADIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.