Provider Demographics
NPI:1063482180
Name:DANI, ROOPA (MD)
Entity Type:Individual
Prefix:
First Name:ROOPA
Middle Name:
Last Name:DANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROOPA
Other - Middle Name:MAHENDRA
Other - Last Name:JOGANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2370 CORPORATE CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7760
Mailing Address - Country:US
Mailing Address - Phone:702-910-3950
Mailing Address - Fax:706-778-2264
Practice Address - Street 1:9280 W SUNSET RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4861
Practice Address - Country:US
Practice Address - Phone:702-844-4846
Practice Address - Fax:702-844-4847
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11663207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063482180Medicaid
NVFZ154Y (CQ328B)Medicare PIN
NV105628Medicare PIN
H68482Medicare UPIN
NVFZ154Z (CQ328A)Medicare PIN