Dr. Michel Daccache Oral and Maxillofacial Surgery , LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S2-112C Issued in NV

Legal business name

DR. MICHEL DACCACHE ORAL AND MAXILLOFACIAL SURGERY , LTD

Doing business as

Oral and Maxillofacial Surgery

Practice address

1701 W Charleston Blvd
Suite 520
Las Vegas, NV 89102-2325

Phone

(702) 750-9444

NPI assigned

Apr 22, 2011

Last updated

Mar 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michel DaccacheNPI 1285881243

Title

Owner

Phone

(775) 750-6789

Specialties & licenses 1

Addresses

Other names 1

• Oral and Maxillofacial Surgery Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michel Daccache, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1285881243
  NPD (past) Authorized official
• Spencer Armuth, DMD MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1194145227
  NPD (past)

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1851682041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD",
            "address_2": "#520",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022325",
            "telephone_number": "702-750-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD",
            "address_2": "SUITE 520",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022325",
            "telephone_number": "702-750-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHEL DACCACHE ORAL AND MAXILLOFACIAL SURGERY , LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "DACCACHE",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-750-6789"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NV",
            "license": "S2-112C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.