NPIMap

Organization Active NPI

Optic Gallery

Doing business as Dr Youngs office

  • Health Maintenance Organization
  • Las Vegas, NV
National Provider Identifier
1740209691
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
328 Issued in NV
Legal business name
OPTIC GALLERY
Doing business as
Dr Youngs office
Practice address
1930 Village Center Cir Ste 10
Las Vegas, NV 89134-6238
Phone
(702) 240-2121
Fax
(702) 240-5858
NPI assigned
Jul 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jennifer C Mallinger, O.D.NPI 1083659254
Title
Partner
Phone
(702) 240-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 328 NV Primary

Addresses

Primary practice location

1930 Village Center Cir Ste 10
Las Vegas, NV 89134-6238

Mailing address

2146 Orchard Mist St
Las Vegas, NV 89135-1562
Phone (702) 869-4588

Other names 1

  • Dr Youngs office Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Youngs Office2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1930 Village Center Cir
Ste 10
Las Vegas, NV 89134
Phone (702) 240-2121

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740209691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 ORCHARD MIST ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351562",
            "telephone_number": "702-869-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 VILLAGE CENTER CIR STE 10",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346238",
            "telephone_number": "702-240-2121",
            "fax_number": "702-240-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC GALLERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALLINGER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-240-2121",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NV",
            "license": "328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Youngs office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 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.