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Contact Information

MODERN DENTAL SPECIALIST, LLC
2560 S MARYLAND PKWY STE 5&6
LAS VEGAS, NV89109-1695
 Phone: 702-200-9000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for MODERN DENTAL SPECIALIST LLC · (Female)

NPI # 1487344032
Status Active
Credentials
Entity Individual
Enumeration date 05/08/2023
Last updated 05/08/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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