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THE DENTAL IMPLANT SOURCE NPI 1457496077


NPI Information

NPI: 1457496077
Provider Name: THE DENTAL IMPLANT SOURCE

Doing Business As: CHEYENNE ADVANCED DENTAL ARTS

Classification: Dentist - 1223P0700X
Entity Type: Organization

Specialization: Prosthodontics

Address:
8960 W CHEYENNE AVE UNIT 190
LAS VEGAS, NV
ZIP 89129
Phone: (702) 367-4121
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THE DENTAL IMPLANT SOURCE is a prosthodontics dentist in Las Vegas, NV. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. THE DENTAL IMPLANT SOURCE NPI is 1457496077. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Cheyenne Advanced Dental Arts.

The provider's business location address is:

8960 W CHEYENNE AVE UNIT 190
LAS VEGAS, NV
ZIP 89129-929
Phone: (702) 367-4121
Fax: (702) 367-4021

The provider's authorized official is Lyle Scott Brooksby .
The authorized official title is President and has the following contact phone number (702) 367-4121.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0700XDentistProsthodontics2543NEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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