Active NPI
Earl J Colbert
- Orthodontics and Dentofacial Orthopedics Dentistry
- Las Vegas, NV
National Provider Identifier
1982788626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 22591
- Practice address
- 5527 S Rainbow Blvd Ste a
Las Vegas, NV 89118-1882 - Phone
- (702) 367-4440
- Fax
- (702) 365-0723
- NPI assigned
- Oct 25, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 22591 | NV | Primary |
Addresses
Primary practice location
5527 S Rainbow Blvd Ste a
Las Vegas, NV 89118-1882
Mailing address
PO Box 17179
Irvine, CA 92623-7179
Phone (949) 567-3176
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 |
|---|---|---|---|
| 22591 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Dental Group, PC | 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, 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": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982788626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 17179",
"city": "IRVINE",
"state": "CA",
"postal_code": "926237179",
"telephone_number": "949-567-3176",
"fax_number": "949-567-3185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5527 S RAINBOW BLVD STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891181882",
"telephone_number": "702-367-4440",
"fax_number": "702-365-0723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBERT",
"first_name": "EARL",
"middle_name": "J",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NV",
"license": "22591",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.