Active NPI
Peyman Bastani, DMD
- Dentist
- Las Vegas, NV
National Provider Identifier
1750149381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8042
- Practice address
- 1707 W Charleston Blvd Ste 290
Las Vegas, NV 89102-2353 - Phone
- (702) 774-5134
- NPI assigned
- Mar 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 8042 | NV | Primary |
Addresses
Primary practice location
1707 W Charleston Blvd Ste 290
Las Vegas, NV 89102-2353
Mailing address
100 Chilpancingo Pkwy Apt 3205
Pleasant Hill, CA 94523-1376
Phone (925) 852-4641
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8042 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1750149381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CHILPANCINGO PKWY APT 3205",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945231376",
"telephone_number": "925-852-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 W CHARLESTON BLVD STE 290",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891022353",
"telephone_number": "702-774-5134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTANI",
"first_name": "PEYMAN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-08",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "8042",
"primary": true
}
],
"identifiers": [],
"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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.