Individual provider Active NPI

Arlenita Oquendo Gomez-Croddy, D. D. S.

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1790871358
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7600 Issued in NV
Practice address
3700 Pecos McLeod Ste 200
Las Vegas, NV 89121-4259
Phone
(702) 732-2333
Fax
(702) 732-0881
NPI assigned
Oct 4, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7600 NV Primary
General Practice Dentistry 1223G0001X 38533 CA

Addresses

Primary practice location

3700 Pecos McLeod Ste 200
Las Vegas, NV 89121-4259

Mailing address

3700 Pecos McLeod Ste 200
Las Vegas, NV 89121-4259
Phone (702) 732-2333

Other names 1

  • Dr. Maria Arlenita Oquendo Gomez Former name

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
38533CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Enchanted Dental Care PLLC Dentist CurrentSince Feb 18, 2024 Accepting new patients
M. Arlenita O. Gomez-Croddy, DDS, a Professional Dental Corproation Current Accepting new patients

Locations

6600 Madison Ave
Ste 12
Carmichael, CA 95608
Phone (916) 961-4522

3700 Pecos McLeod
Ste 200
Las Vegas, NV 89121
Phone (702) 732-2333

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1790871358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 PECOS MCLEOD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214259",
            "telephone_number": "702-732-2333",
            "fax_number": "702-732-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PECOS MCLEOD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214259",
            "telephone_number": "702-732-2333",
            "fax_number": "702-732-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-CRODDY",
        "first_name": "ARLENITA",
        "middle_name": "OQUENDO",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7600",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA ARLENITA",
            "last_name": "GOMEZ",
            "middle_name": "OQUENDO",
            "prefix": "DR.",
            "credential": "D. D. S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Feb 16, 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.

Verify at the official NPI Registry.