Desert Dental Associates IV, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DESERT DENTAL ASSOCIATES IV, LLC

Doing business as

Maddison Ave Dental

Practice address

4358 W. Chyenne Ave.
North Las Vegas, NV 89032

Phone

(702) 953-2239

Fax

(702) 990-0304

NPI assigned

Dec 2, 2009

Organization subpart

Yes

Parent organization

DESERT DENTAL ASSOCIATES, IV, LLCAs reported in NPPES

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

Authorized official

Name

Matthew Welebir, DDS

Title

Owner- Dentist

Phone

(702) 953-2239

Specialties & licenses 1

Addresses

Other names 1

• Maddison Ave Dental Doing business as

Part of

Desert Dental Associates IV LLC

Locations

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1861720864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 W. CHYENNE AVE.",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-953-2239",
            "fax_number": "702-990-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 W. CHYENNE AVE.",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-953-2239",
            "fax_number": "702-990-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT DENTAL ASSOCIATES IV, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESERT DENTAL ASSOCIATES, IV, LLC",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "WELEBIR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER- DENTIST",
        "authorized_official_telephone_number": "702-953-2239",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maddison Ave Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in North Las Vegas, NV
• Providers in North 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 Dec 2, 2009; 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.