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Contact Information

MODERN DENTAL SPECIALIST, LLC
4610 E SUNSET RD
HENDERSON, NV89014-2202
 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

NPI Number 1407541337
LBN Legal business name MODERN DENTAL SPECIALIST, LLC
Authorized official BENNY KOHANTEB - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/06/2023
Last updated 04/06/2023 - About 3 years 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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