Organization Active NPI

P&G Smiles LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Las Vegas, NV
National Provider Identifier
1962357665
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
P&G SMILES LLC
Practice address
9850 S Maryland Pkwy Ste 1
Las Vegas, NV 89183-7148
Phone
(702) 703-0102
Fax
(702) 723-6773
NPI assigned
Feb 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Prashanti Bollu, D.M.D., M.S., M.B.A.
Title
Orthodontist
Phone
(617) 849-0751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

9850 S Maryland Pkwy Ste 1
Las Vegas, NV 89183-7148

Mailing address

9850 S Maryland Pkwy Ste 1
Las Vegas, NV 89183-7148
Phone (702) 703-0102

Other names 1

  • P&G Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PG Orthodontics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

9850 S Maryland Pkwy
Ste 1
Las Vegas, NV 89183
Phone (702) 703-0102

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1962357665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 S MARYLAND PKWY STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837148",
            "telephone_number": "702-703-0102",
            "fax_number": "702-723-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 S MARYLAND PKWY STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891837148",
            "telephone_number": "702-703-0102",
            "fax_number": "702-723-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P&G SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "BOLLU",
        "authorized_official_first_name": "PRASHANTI",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "617-849-0751",
        "authorized_official_credential": "D.M.D., M.S., M.B.A."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P&G Orthodontics",
            "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 Feb 27, 2026; 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.