Individual provider Active NPI

Raymond Kent Simister, D.M.D.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1760423164
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
692 Issued in NV
Practice address
4610 Meadows LN
Las Vegas, NV 89107-2965
Phone
(702) 878-7700
Fax
(702) 878-4630
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 692 NV Primary

Addresses

Primary practice location

4610 Meadows LN
Las Vegas, NV 89107-2965

Mailing address

4610 Meadows LN
Las Vegas, NV 89107-2965
Phone (702) 878-7700

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
I20160421000928 NV Order and Referring Only - DentistPractitioner - Dentist 8921306192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
692NVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1760423164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 MEADOWS LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072965",
            "telephone_number": "702-878-7700",
            "fax_number": "702-878-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 MEADOWS LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072965",
            "telephone_number": "702-878-7700",
            "fax_number": "702-878-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMISTER",
        "first_name": "RAYMOND",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.