BRYCE D LEAVITT (NPI# 1093919417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093919417 |
| Entity Type | Individual |
| Full Name | BRYCE D LEAVITT |
| Credential | DMD, MD |
| Practice Address |
670 S Green Valley Pkwy #15 Henderson NV 89052 |
| Practice Telephone | 7026853700 |
| Practice Fax Number | 7026853701 |
| Mailing Telephone | 7026853700 |
| Mailing Fax Number | 7026853701 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
SZ-127 | NV | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6227 | NV | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 55354 | MN | Allopathic & Osteopathic Physicians |
| N | 204E00000X | Oral & Maxillofacial Surgery | D12476 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 884127000 | 05 | |
| WI | 33826800 | 05 | |
| MN | ENROLLED | 05 |
| Street Address |
670 S GREEN VALLEY PKWY #15 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275902504 | Katherine A. Keeley, Md, PC | Dentist | 2649 Wigwam Pkwy Ste 102, Henderson, NV 89074-7310 | 2015-09-16 |
| 1891942652 | Mahyar Ali Karimi | Dentist | 1701 N Green Valley Pkwy Ste 2e, Henderson, NV 89074-5886 | 2008-08-24 |
| 1740368935 | Robert Gene Wagoner II | Dentist | 801 N. Elm Street, Henderson, KY 42420-2705 | 2006-11-02 |
| 1780794297 | Ryan C Gibson | Dentist | 670 S. Green Valley Pkwy #115, Henderson, NV 89052 | 2006-08-30 |
| 1750638334 | Green River Oral Surgery | Dentist | 801 N Elm St, Henderson, KY 42420-2705 | 2012-08-13 |
| 1871820530 | Gibson & Leavitt Oral, Maxillofacial and Implant Surgery Pllc | Dentist | 670 S. Green Valley Pkwy #115, Henderson, NV 89052 | 2009-11-17 |
| 1104079755 | Steve J Huang | Dentist | 1701 N Green Valley Pkwy, Suite 2e, Henderson, NV 89074-5885 | 2008-10-28 |
| 1770607038 | Ronald Albert Moss | Dentist | 451 Ruin Creek Road, Suite 105, Henderson, NC 27536 | 2007-03-19 |
| 1255465092 | George E Bonn | Dentist | 1701 N Green Valley Pkwy, #2e, Henderson, NV 89074 | 2007-03-15 |
| 1710904669 | Dr Ronald A Moss Pa | Dentist | 451 Ruin Creek Road, Suite 105, Henderson, NC 27536 | 2006-07-16 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.