NPIMap

Organization Active NPI

Matthew Kikuchi DMD PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1780051367
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
S2-138 Issued in NV
Legal business name
MATTHEW KIKUCHI DMD PLLC
Practice address
5765 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5625
Phone
(702) 876-6337
Fax
(702) 876-2988
NPI assigned
Aug 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Matthew Kikuchi, DMD
Title
Sole Member
Phone
(702) 343-4720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X S2-138 NV Primary

Addresses

Primary practice location

5765 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5625

Mailing address

5765 S Fort Apache Rd Ste 110
Las Vegas, NV 89148-5625
Phone (702) 876-6337

National Provider Directory

National Provider Directory

Locations

5765 S Fort Apache Rd
Ste 110
Las Vegas, NV 89148
Phone (702) 876-6337

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1780051367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5765 S FORT APACHE RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485625",
            "telephone_number": "702-876-6337",
            "fax_number": "702-876-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5765 S FORT APACHE RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485625",
            "telephone_number": "702-876-6337",
            "fax_number": "702-876-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW KIKUCHI DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "KIKUCHI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "702-343-4720",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-138",
            "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 19, 2019; 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.