MJD, LLC (NPI# 1205338563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205338563 |
| Entity Type | Organization |
| Organization Name | MJD, LLC |
| Other Organization Name | NEVADAOMS |
| Practice Address |
4544 S Pecos Rd Las Vegas NV 89121-5923 |
| Practice Telephone | 7024360900 |
| Practice Fax Number | 7024360636 |
| Mailing Telephone | 7024360900 |
| Mailing Fax Number | 7024360636 |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |
| Authorized Official Name | DR. MICHEL JOSEPH DACCACHE (OWNER) |
| Authorized Official Telephone | 7027509444 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | MJD, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
S2-112C | NV | Dental Providers |
| Other Name | Type Code |
|---|---|
| NevadaOMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558897884 | Mjd, LLC | Dentist | 1701 W Charleston Blvd, 520, Las Vegas, NV 89102-2325 | 2017-05-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | MJD, LLC | 2422 Stewart Road, Muscatine, IA 52761 |
| Street Address |
4544 S PECOS RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89121-5923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649358300 | Albert Theodore Twesme | Dentist | 4544 S Pecos Rd, Las Vegas, NV 89121-5923 | 2006-11-01 |
| 1447422035 | A. Ted Twesme, D.d.s., Ltd. | Clinic/Center | 4544 S Pecos Rd, Las Vegas, NV 89121-5923 | 2008-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598379117 | Western State Behavioral Health and Psychiatric Services | Psychologist | 3910 Pecos-mcleod Interconnect, Las Vegas, NV 89121 | 2020-09-01 |
| 1962025155 | Arieste Diaz Perez | Clinic/Center | 3777 Pecos-mcleod Interconnect, Suite 101, Las Vegas, NV 89121 | 2020-05-21 |
| 1366071904 | Vanesa Silva | Behavior Technician | 4714 Flamigo Rd, Las Vegas, NV 89121 | 2020-04-06 |
| 1053955732 | Valente Solis Santiago | Technician | 2785 E. Desert Inn Rd Ste. 240, Las Vegas, NV 89121 | 2019-11-05 |
| 1750938981 | Ken Ernst | Rehabilitation Practitioner | Primary Solutions Medical Billing, 4525 S. Sandhill Rd Ste #112, Las Vegas, NV 89121 | 2019-08-22 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| 1679127096 | Wilma Guadalupe Nunez | Chore Provider | 2860 East Flamingo, Suite C, Las Vegas, NV 89121 | 2019-07-25 |
| 1487213807 | Karla Susana Ayala | Chore Provider | 2860 E. Flamingo Rd Ste K., Las Vegas, NV 89121 | 2019-06-10 |
| 1447819164 | Jovita Garcia-perez | Chore Provider | 2860 E. Flamingo Suite C, Suite C, Las Vegas, NV 89121 | 2019-06-06 |
| 1164081972 | Maria Isabel Castellanos Gonzalez | Chore Provider | 2860 E. Flamingo Rd Ste K, Las Vegas, NV 89121 | 2019-06-06 |
| Find all providers in zip 89121 | ||||
| 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 |
|---|---|---|---|---|
| 1568098309 | Moinca R Ponce | Dentist | 9450 West Russell Rd, Suite #103, Las Vegas, NV 89148 | 2020-03-12 |
| 1063061976 | Axiom Dentistry, LLC | Dentist | 8965 S Eastern Ave # 110, Las Vegas, NV 89123-4891 | 2019-09-04 |
| 1922657808 | Axiom Dentistry, LLC | Dentist | 410 S Rampart Blvd Ste 360, Las Vegas, NV 89145-5730 | 2019-09-04 |
| 1922533785 | Providence Dental Dhillon Pllc | Dentist | 10965 Lavender Hill Dr, # 6200, Las Vegas, NV 89135-2950 | 2017-04-28 |
| 1790136380 | Jordan Swarbrick | Dentist | 6180 N Decatur Blvd Ste 100, Las Vegas, NV 89130-1505 | 2016-06-25 |
| 1861848400 | Kevin Nowins | Dentist | 630 S Rancho Dr Ste B, Las Vegas, NV 89106-4849 | 2016-05-13 |
| 1922489350 | Falk Oral & Facial Surgery, Pllc | Dentist | 6200 North Durango Drive, Suite 100, Las Vegas, NV 89149-4408 | 2015-06-11 |
| 1760739825 | Michael S Moody | Dentist | 6200 N Durango Dr Ste 100, Las Vegas, NV 89149 | 2012-08-08 |
| 1467713859 | James J Schlesinger IIi | Dentist | 2040 W Charleston Blvd Ste 201, Las Vegas, NV 89102-2287 | 2012-06-02 |
| 1922365402 | Blair Alexander Isom | Dentist | 9368 Bronze River Ave, Las Vegas, NV 89149-1687 | 2012-04-20 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on MJD, LLC.
| 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.