NPIMap

Organization Active NPI

Modern Dental Specialist, LLC

Doing business as Modern Dental

  • Endodontics
  • Las Vegas, NV
National Provider Identifier
1912607433
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
MODERN DENTAL SPECIALIST, LLC
Doing business as
Modern Dental
Practice address
4618 Meadows LN
Las Vegas, NV 89107-2956
Phone
(702) 623-3200
NPI assigned
Mar 3, 2023
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Anastasia Savcic
Title
Human Resourse
Phone
(702) 623-3200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary
Periodontics 1223P0300X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X

Addresses

Primary practice location

4618 Meadows LN
Las Vegas, NV 89107-2956

Mailing address

4618 Meadows LN
Las Vegas, NV 89107-2956
Phone (702) 623-3200

Other practice location 1

4610 E Sunset Rd
Henderson, NV 89014-2202
Phone (702) 200-9000

Other practice location 2

6388 W Sahara Ave
Las Vegas, NV 89146-3050
Phone (702) 288-7200

Other names 1

  • Modern Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Dental Specialist LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1912607433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 MEADOWS LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072956",
            "telephone_number": "702-623-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 MEADOWS LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072956",
            "telephone_number": "702-623-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 E Sunset Rd",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890142202",
            "country_code": "US",
            "telephone_number": "702-200-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6388 W Sahara Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891463050",
            "country_code": "US",
            "telephone_number": "702-288-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN DENTAL SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SAVCIC",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "HUMAN RESOURSE",
        "authorized_official_telephone_number": "702-623-3200"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.