WATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION (NPI# 1427238534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427238534 |
| Entity Type | Organization |
| Organization Name | WATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION |
| Other Organization Name | SHADOW MOUNTAIN DENTAL GROUP |
| Practice Address |
6525 N Decatur Blvd Suite 150 Las Vegas NV 89131 |
| Mailing Address |
2860 Michelle 2nd Floor Irvine CA 92606-1009 |
| Practice Telephone | 7025771941 |
| Practice Fax Number | 7023957813 |
| Mailing Telephone | 7145083600 |
| Mailing Fax Number | 7143682092 |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-07 |
| Authorized Official Name | DR. LYNDA C WATANABE (OWNER DOCTOR) |
| Authorized Official Telephone | 7025771941 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| SHADOW MOUNTAIN DENTAL GROUP | Doing Business As Name - Organization |
| Street Address |
6525 N DECATUR BLVD SUITE 150 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982001566 | Nicole K.i. Fernandez | Dentist | 6525 N Decatur Blvd, Suite 150, Las Vegas, NV 89131-2992 | 2014-11-26 |
| 1174824148 | Romulo Joseph Guideng Jr. | Dentist | 6525 N Decatur Blvd, Ste 150, Las Vegas, NV 89131-2992 | 2010-11-08 |
| 1619200763 | Meredith Anne Wolf | Dentist | 6525 N Decatur Blvd, Suite 150, Las Vegas, NV 89131-2992 | 2009-09-08 |
| 1104001155 | Sako H Karakozian | Dentist | 6525 N Decatur Blvd, Suite 150, Las Vegas, NV 89131-2992 | 2008-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013497973 | Vivian Matti | Technician | 7155 Royal Melbourne Dr, Las Vegas, NV 89131 | 2018-08-20 |
| 1235656810 | Yolonda Chantelle Johnson | Massage Therapist | 8400 Farm Road #150, Las Vegas, NV 89131 | 2017-08-24 |
| 1528581865 | Nevada Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8491 Farm Rd, Las Vegas, NV 89131 | 2017-07-19 |
| 1992252522 | Brittany Ann Brumfield | Behavioral Analyst | 7580 Splashing Rock Drive, Las Vegas, NV 89131 | 2016-09-01 |
| 1144682220 | Integrative Health & Wellness Practices LLC | Chiropractor | 6628 Skypointe Drive Suite 113, Las Vegas, NV 89131 | 2016-03-28 |
| 1659747137 | Daniel Leiner | Pharmacist | 8410 W. Farm Road, Las Vegas, NV 89131 | 2015-08-19 |
| 1669860938 | Adrienne K Stauffer-snell | Chiropractor | 8400 Farm Road, Suite 150, Las Vegas, NV 89131 | 2015-01-08 |
| 1568897874 | Arturo Hernandez | Physical Therapist | 6535 N Buffalo Dr Ste 120, Las Vegas, NV 89131 | 2013-09-05 |
| 1750727996 | Sheppards Health Education &psychiatric Services | Counselor | 5827 Falling Stream Street, Las Vegas, NV 89131 | 2013-05-15 |
| 1962748038 | Phases of Me, Inc. | Counselor | 6624 Sky Pointe Drive, Las Vegas, NV 89131 | 2012-12-18 |
| Find all providers in zip 89131 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851901755 | Christian J. Otteson | Dentist | 4750 W Sahara Ave Ste 12, Las Vegas, NV 89102-3559 | 2020-08-05 |
| 1811506082 | Jorge Jimenez-marquez, Dmd, Pllc | Dentist | 110 E Bruner Ave Ste 130, Las Vegas, NV 89183-5700 | 2020-07-23 |
| 1235747643 | Sean Patrick Fitzgibbons | Dentist | 6545 Ditmars St, Las Vegas, NV 89166-8026 | 2020-07-21 |
| 1467079806 | Cristian Omar Sosa | Dentist | 860 S Rancho Dr Ste 3, Las Vegas, NV 89106-3828 | 2020-07-01 |
| 1538786421 | Colette Laree Fuglaar | Dentist | 6974 Walden Park St, Las Vegas, NV 89166-8044 | 2020-06-26 |
| 1083233001 | Flamingo Dental Partners LLC | Dentist | 6680 W Flamingo Rd Ste A, Las Vegas, NV 89103-2189 | 2020-04-09 |
| 1356979603 | Kim Dewayne Kemmerly | Dentist | 5905 W Charleston Blvd Apt 250, Las Vegas, NV 89146-1375 | 2020-03-31 |
| 1730714569 | Gulati Highlands Dentistry, PC | Dentist | 4380 W. Cactus Ave, Suite 100, Las Vegas, NV 89141 | 2020-03-12 |
| 1598396236 | Najand Dental, LLC | Dentist | 8525 Blue Diamond Road Suite #110, Las Vegas, NV 89178 | 2020-01-31 |
| 1831739150 | Vivi Baldwin | Dentist | 7785 N Durango Dr Ste 140, Las Vegas, NV 89131-8002 | 2020-01-15 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on WATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION.
| 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.