Preventative Diagnostic Center LLC

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

PREVENTATIVE DIAGNOSTIC CENTER LLC

Practice address

6620 S Tenaya Way Ste 120
Las Vegas, NV 89113-1962

Phone

(702) 534-7900

NPI assigned

Jun 8, 2023

Organization subpart

No

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

Authorized official

Name

Kevin Blair

Title

Manager/Owner

Phone

(702) 493-8816

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1891489050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 S TENAYA WAY STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131962",
            "telephone_number": "702-534-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 S TENAYA WAY STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131962",
            "telephone_number": "702-534-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "702-493-8816"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.