Individual provider Active NPI

Nicole Ameli

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1790243673
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7369 Issued in NV
Practice address
3505 E Harmon Ave
Las Vegas, NV 89121-5093
Phone
(725) 237-3940
Fax
(702) 796-1300
NPI assigned
Mar 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 7369 NV Primary

Addresses

Primary practice location

3505 E Harmon Ave
Las Vegas, NV 89121-5093

Mailing address

9816 Camden Rose CT
Las Vegas, NV 89134-5906
Phone (702) 882-9581

Other practice location 1

301 W 6th Ave
Denver, CO 80204-5182
Phone (303) 436-6000

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

LicenseStateTypeSpecialty
7369NVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1790243673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 CAMDEN ROSE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891345906",
            "telephone_number": "702-882-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E HARMON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215093",
            "telephone_number": "725-237-3940",
            "fax_number": "702-796-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802045182",
            "country_code": "US",
            "telephone_number": "303-436-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMELI",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-09",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7369",
            "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 Nov 30, 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.