Provider Demographics
NPI:1477574515
Name:STARBRITE DENTAL, LLC
Entity Type:Organization
Organization Name:STARBRITE DENTAL, LLC
Other - Org Name:BRITESMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-452-8323
Mailing Address - Street 1:8430 FARM RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-8166
Mailing Address - Country:US
Mailing Address - Phone:702-452-8323
Mailing Address - Fax:702-658-6832
Practice Address - Street 1:8430 FARM RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-8166
Practice Address - Country:US
Practice Address - Phone:702-452-8323
Practice Address - Fax:702-658-6832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty