Provider Demographics
NPI:1013442086
Name:ALIGN BRACES
Entity type:Organization
Organization Name:ALIGN BRACES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAHNAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:702-242-5251
Mailing Address - Street 1:4250 SIMMONS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0768
Mailing Address - Country:US
Mailing Address - Phone:702-242-5251
Mailing Address - Fax:702-243-2893
Practice Address - Street 1:6127 S RAINBOW BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3256
Practice Address - Country:US
Practice Address - Phone:702-242-5251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACES BRACES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty