MARK I DEGEN (NPI# 1215002225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215002225 |
| Entity Type | Individual |
| Full Name | MARK I DEGEN |
| Credential | D.D.S., M.D. |
| Practice Address |
4730 S Fort Apache Rd Ste 390 Las Vegas NV 89147-7945 |
| Practice Telephone | 7022539090 |
| Practice Fax Number | 7022539083 |
| Mailing Telephone | 7022539090 |
| Mailing Fax Number | 7022539083 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-05-22 |
| 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 |
10535 | NV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | GROUP NPI NUMBER | 1598946261 | 01 |
| NV | TAX ID | 200078388 | 01 |
| Street Address |
4730 S FORT APACHE RD STE 390 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89147-7945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316918998 | Maria C Molina | Internal Medicine | 4730 S Fort Apache Rd, Suite150, Las Vegas, NV 89147-7945 | 2006-01-31 |
| 1194133959 | Alvin Lourenz E Ucab | Nurse Practitioner | 4730 S Fort Apache Rd, 150, Las Vegas, NV 89147-7945 | 2014-07-24 |
| 1881718450 | Deborah Anne Muller | Nurse Practitioner | 4730 S Fort Apache Rd, Las Vegas, NV 89147-7945 | 2007-03-19 |
| 1669530929 | Inga A Polyak | Psychiatry & Neurology | 4730 S Fort Apache Rd, Suite 390, Las Vegas, NV 89147-7945 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593621 | Ata Group Lv | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 10170 W Tropicana Ave Ste 156-211, Las Vegas, NV 89147 | 2020-06-25 |
| 1104474022 | Jacklyn Siagatonu | Behavior Technician | 7125 Grand Montecito Parkway, Las Vegas Nv, N Las Vegas, NV 89147 | 2019-09-04 |
| 1700388253 | Pr Acquisition Corporation | Clinic/Center | 9892 W Flamingo Road, Las Vegas, NV 89147 | 2018-03-01 |
| 1629578836 | Jonathan Balagot Dizon | Optometrist | 4160 S Durango Dr, Las Vegas, NV 89147 | 2018-02-14 |
| 1346751526 | Ignite Teen Treatment, LLC | Clinic/Center | 3722 Lone Mesa Dr, Las Vegas, NV 89147 | 2017-10-16 |
| 1306365275 | Diversified Behavioral Health Services LLC | Community/Behavioral Health | 9636 W.cherokee Ave, Las Vegas, NV 89147 | 2017-09-12 |
| 1356874713 | A8a Personal Care Solution LLC | In Home Supportive Care | 8879 West Flamingo, Ste 101, Las Vegas, NV 89147 | 2017-04-04 |
| 1154782191 | Ma Leah Roble Maravillas | Behavioral Analyst | 9999 W Katie Ave Suite 1313, Las Vegas, NV 89147 | 2016-03-18 |
| 1285010959 | Samantha Lauren Pope | Specialist | 9353 W. Twain Ave, Apt 113, Las Vegas, NV 89147 | 2015-08-05 |
| 1215311980 | Daniel Dorado | Marriage & Family Therapist | 9848 Gallo Dr, Las Vegas, NV 89147 | 2015-07-13 |
| Find all providers in zip 89147 | ||||
| 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 MARK I DEGEN.
| 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.