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Contact Information

BACCHUS PC
880 SEVEN HILLS DR STE 140
HENDERSON, NV89052-4372
 Phone: 702-844-4840
 Fax: 702-844-4843
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Urgent Care

261QU0200X
Indicates primary specialty

NPI Profile & details for BACCHUS PC

NPI # 1134628480
LBN Legal business name BACCHUS PC
Authorized official BEVERLY DENDARY - (CREDENTIALING MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/01/2018
Last updated 04/01/2026 - About 2 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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