Provider Demographics
NPI:1922371699
Name:LVOS, LLC
Entity Type:Organization
Organization Name:LVOS, LLC
Other - Org Name:AXIOM CENTER FOR ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELEBIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-228-2218
Mailing Address - Street 1:8551 W LAKE MEAD BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7642
Mailing Address - Country:US
Mailing Address - Phone:702-228-2218
Mailing Address - Fax:
Practice Address - Street 1:8551 W LAKE MEAD BLVD STE 260
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7642
Practice Address - Country:US
Practice Address - Phone:702-228-2218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS-7-301223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty