NPIMap

Individual provider Active NPI

Richard Brian Nelson, DDS

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1962657494
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5136 Issued in NV
Practice address
2560 Montessouri St
Suite 109
Las Vegas, NV 89117-3061
Phone
(702) 822-1008
Fax
(702) 822-1284
NPI assigned
Nov 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5136 NV Primary

Addresses

Primary practice location

2560 Montessouri St
Suite 109
Las Vegas, NV 89117-3061

Mailing address

2560 Montessouri St
Suite 109
Las Vegas, NV 89117-3061
Phone (702) 822-1008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5136NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Dental Professional, Quirt, Kruyer, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1962657494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 MONTESSOURI ST",
            "address_2": "SUITE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173061",
            "telephone_number": "702-822-1008",
            "fax_number": "702-822-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 MONTESSOURI ST",
            "address_2": "SUITE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173061",
            "telephone_number": "702-822-1008",
            "fax_number": "702-822-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RICHARD",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 25, 2008; 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.