Jacqueline Nicole Patterson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

5804 Issued in NV

Practice address

2560 Montessouri St Ste 109
Las Vegas, NV 89117-3063

Phone

(702) 362-9353

NPI assigned

Nov 7, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dentist

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Rd Prabhu-Lata K Shete MDS LTD

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1912995309
  Medicare reassignment NPD (past)
• Chad N Gubler DDS Casino Direct LTD

  • Dentist
  • Las Vegas, NV
  • NPI 1548084759
  NPD
• Rd Prabhu-Lata K Shete MDS LTD

  • Sleep Disorder Diagnostic Clinic/Center
  • Henderson, NV
  • NPI 1790144897
  NPD (past)

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1790939403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 PLEASANT LAKE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172253",
            "telephone_number": "702-336-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 MONTESSOURI ST STE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173063",
            "telephone_number": "702-362-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5804",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Rashun Patterson
• Damon Tieshe Patterson Jr.
• Diamond Patterson
• Faatimah M Patterson, SLP
• Georgette I Patterson, CPC INTERN
• Joshua Duane Patterson, M.D.
• Justin Patterson
• Kimberly Patterson
• Larisha Patterson
• Marcella Patterson

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.