NPIMap

Organization Active NPI

Little Smiles Pediatric Dentistry

  • Pediatric Dentistry
  • Las Vegas, NV
National Provider Identifier
1972744373
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
S6-47 Issued in NV
Legal business name
LITTLE SMILES PEDIATRIC DENTISTRY
Practice address
6169 S Rainbow Blvd Ste 100
Las Vegas, NV 89118-3231
Phone
(702) 658-6700
Fax
(702) 450-6711
NPI assigned
Mar 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Authorized official

Name
Dr. Michael Fredrick Nelson, D.D.S.
Title
Doctor
Phone
(702) 658-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X S6-47 NV Primary

Addresses

Primary practice location

6169 S Rainbow Blvd Ste 100
Las Vegas, NV 89118-3231

Mailing address

6169 S Rainbow Blvd Ste 100
Las Vegas, NV 89118-3231
Phone (702) 658-6700

Other identifiers 2

IdentifierTypeStateIssuer
100511590MedicaidNV
1988252OtherNVUNITED CONCORDIA

National Provider Directory

National Provider Directory
Tax ID family
Little Smiles Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1972744373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 S RAINBOW BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183231",
            "telephone_number": "702-658-6700",
            "fax_number": "702-450-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 S RAINBOW BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183231",
            "telephone_number": "702-658-6700",
            "fax_number": "702-450-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SMILES PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "FREDRICK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "702-658-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-47",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100511590",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1988252",
            "state": "NV"
        }
    ],
    "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 Mar 11, 2010; 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.