Provider Demographics
NPI:1861839284
Name:FIRST DENTISTS LLC
Entity Type:Organization
Organization Name:FIRST DENTISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-641-5566
Mailing Address - Street 1:4416 E BONANZA RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-6348
Mailing Address - Country:US
Mailing Address - Phone:702-641-5566
Mailing Address - Fax:
Practice Address - Street 1:4416 E BONANZA RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-6348
Practice Address - Country:US
Practice Address - Phone:702-641-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty