Active NPI
Manny Rapp, DDS
- Pediatric Dentistry
- Henderson, NV
National Provider Identifier
1962843961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- S6-26
- Practice address
- 1701 N. Green Valley Pkwy #8E
Henderson, NV 89074 - Phone
- (702) 492-1955
- Fax
- (702) 492-7663
- NPI assigned
- Jul 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | S6-26 | NV | Primary |
| Pediatric Dentistry | 1223P0221X | 3742 | NV |
Addresses
Primary practice location
1701 N. Green Valley Pkwy #8E
Henderson, NV 89074
Mailing address
1701 N. Green Valley Pkwy #8E
Henderson, NV 89074
Phone (702) 492-1955
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S6-26 | Other | NV | SPECIALTY LICENSE |
| 3742 | Other | NV | STATE DENTAL LIC NUMBER |
| 02-0637337 | Other | TAX ID # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S6-26 | NV | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adaven Childrens Dentistry | Pediatric Dentistry | 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.
-
- Pediatric Dentistry
- Henderson, NV
- NPI 1912924820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1962843961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 N. GREEN VALLEY PKWY #8E",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89074",
"telephone_number": "702-492-1955",
"fax_number": "702-492-7663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N. GREEN VALLEY PKWY #8E",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89074",
"telephone_number": "702-492-1955",
"fax_number": "702-492-7663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPP",
"first_name": "MANNY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-08",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NV",
"license": "S6-26",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NV",
"license": "3742",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIALTY LICENSE",
"identifier": "S6-26",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DENTAL LIC NUMBER",
"identifier": "3742",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "02-0637337",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.