Shahrestani Grand Canyon Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHAHRESTANI GRAND CANYON MODERN DENTISTRY, PC

Practice address

9560 W Skye Canyon Park Dr Ste 100
Las Vegas, NV 89166-6802

Phone

(702) 800-5711

NPI assigned

May 7, 2024

Organization subpart

No

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

Authorized official

Name

Ali Shahrestani

Title

DMD

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Vizconde, DMD

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1780405746
  NPD

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1841048865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9560 W SKYE CANYON PARK DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666802",
            "telephone_number": "702-800-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRESTANI GRAND CANYON MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianna Shahinyan
• Saba Shahirdavarpanah, BCBA, LBA
• Sarine Gayaneh Shahmirian
• Saadia Shahnawaz
• Shahrestani Canyon Pointe Dental Group PC
• Shahrestani Las Vegas Modern Dentistry, PC
• Shahrestani Rancho Smiles Dentistry, PC
• Shahrestani Shadow Mountain Smiles Dentistry, PC
• Shahrestani Sunrise Modern Dentistry, PC
• Ali Shahrestani, DDS

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, 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 May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.