Individual provider Active NPI

Farah Divanbeigi, DDS

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1982730511
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3047 Issued in NV
Practice address
501 S Rancho Dr
Suite G48
Las Vegas, NV 89106
Phone
(702) 474-2454
Fax
(702) 474-2946
NPI assigned
Feb 26, 2007
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3047 NV Primary

Addresses

Primary practice location

501 S Rancho Dr
Suite G48
Las Vegas, NV 89106

Mailing address

501 S Rancho Dr
Suite G48
Las Vegas, NV 89106
Phone (702) 474-2454

Other identifiers 1

IdentifierTypeStateIssuer
2202781MedicaidNV

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
3047NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dentistry of Las Vegas LLC CurrentSince Nov 26, 2023 Accepting new patients

Locations

501 S Rancho Dr
Ste G48
Las Vegas, NV 89106
Phone (702) 474-2454

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1982730511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR",
            "address_2": "SUITE G48",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-474-2454",
            "fax_number": "702-474-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S RANCHO DR",
            "address_2": "SUITE G48",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-474-2454",
            "fax_number": "702-474-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVANBEIGI",
        "first_name": "FARAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "3047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2202781",
            "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 Dec 5, 2023; 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.