Centennial Dermatology and Skin Cancer Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CENTENNIAL DERMATOLOGY AND SKIN CANCER INC

Practice address

5500 Painted Mirage Road
Suite 100
Las Vegas, NV 89149

Phone

(702) 432-3800

NPI assigned

Jul 11, 2012

Organization subpart

No

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

Authorized official

Name

Daniel Taheri, MD

Title

President

Phone

(702) 432-3800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1942565205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "702-432-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 PAINTED MIRAGE ROAD",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89149",
            "telephone_number": "702-432-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL DERMATOLOGY AND SKIN CANCER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "TAHERI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-432-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria De Ceniceros Plaza
• Ana Ceniceros
• Corazon Ceniceros, BSW
• Jose Ceniceros
• Centennial Dermatology and Skin Cancer Inc
• Centennial Family Dentistry
• Centennial Group LLC
• Centennial Hills Hospital Medical Center
• Centennial Hills Hospital Medical Center
• Centennial Hills Hospital Medical Center

• Dermatology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dermatology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.