Kelsey Conrad, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7683 Issued in NV

Practice address

1135 Vitality Dr Ste 130
Henderson, NV 89011-4809

Phone

(702) 359-7401

NPI assigned

Sep 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oweis Union Village Modern Dentistry, PC

  • General Practice Dentistry
  • Henderson, NV
  • NPI 1437733243
  NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1780306308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WIGWAM PKWY UNIT 11209",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748366",
            "telephone_number": "469-274-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 VITALITY DR STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114809",
            "telephone_number": "702-359-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "KELSEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherokee Conley-Garcia, MSW, CSW-I
• Alexandra Nichole Connelly
• Jessica Conner, PSY. D.
• Mary Jo Connery
• Connexpace LLC
• Conscious Healing Therapy LLC
• Denise Consengco
• Amanda Maite Constantin Frias
• Consulting Interventional Cardiology LLC
• Elissa Conte, APN

• General Practice Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.