Provider Demographics
NPI:1598483604
Name:DENTAL SURGERY CENTER OF LAS VEGAS, LLC
Entity Type:Organization
Organization Name:DENTAL SURGERY CENTER OF LAS VEGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:EMETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-505-4404
Mailing Address - Street 1:7670 W LAKE MEAD BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-6651
Mailing Address - Country:US
Mailing Address - Phone:702-505-4404
Mailing Address - Fax:
Practice Address - Street 1:7670 W LAKE MEAD BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6651
Practice Address - Country:US
Practice Address - Phone:702-505-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical