Individual provider Active NPI

Sulabh Shroff

  • Pediatric Dentistry
  • Las Vegas, NV
National Provider Identifier
1811284243
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
S6-130 Issued in NV
Practice address
526 S Tonopah Dr
#200
Las Vegas, NV 89106-4043
Phone
(702) 435-5015
Fax
(702) 366-1483
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X S6-130 NV Primary

Addresses

Primary practice location

526 S Tonopah Dr
#200
Las Vegas, NV 89106-4043

Mailing address

526 S Tonopah Dr
#200
Las Vegas, NV 89106-4043
Phone (702) 435-5015

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160926002108 NV Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2961799580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S6-130NVMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1811284243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR",
            "address_2": "#200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064043",
            "telephone_number": "702-435-5015",
            "fax_number": "702-366-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR",
            "address_2": "#200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064043",
            "telephone_number": "702-435-5015",
            "fax_number": "702-366-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROFF",
        "first_name": "SULABH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.