Provider Demographics
NPI:1821823188
Name:CHILDRENS SPECIALISTS OF LAS VEGAS
Entity type:Organization
Organization Name:CHILDRENS SPECIALISTS OF LAS VEGAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:
Authorized Official - Last Name:HYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-606-4094
Mailing Address - Street 1:3585 S TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-3019
Mailing Address - Country:US
Mailing Address - Phone:702-979-3090
Mailing Address - Fax:
Practice Address - Street 1:3585 S TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3019
Practice Address - Country:US
Practice Address - Phone:702-979-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty