MJD, LLC (NPI# 1558897884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558897884 |
| Entity Type | Organization |
| Organization Name | MJD, LLC |
| Other Organization Name | NEVADA OMS |
| Practice Address |
1701 W Charleston Blvd 520 Las Vegas NV 89102-2325 |
| Practice Telephone | 7027509444 |
| Practice Fax Number | 7027509442 |
| Mailing Telephone | 7027509444 |
| Mailing Fax Number | 7027509442 |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2017-05-05 |
| Authorized Official Name | MICHEL DACCACHE (OWNER) |
| Authorized Official Telephone | 7027509444 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| 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 |
|---|---|
| Nevada OMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205338563 | Mjd, LLC | Dentist | 4544 S Pecos Rd, Las Vegas, NV 89121-5923 | 2018-03-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | MJD, LLC | 2422 Stewart Road, Muscatine, IA 52761 |
| Street Address |
1701 W CHARLESTON BLVD 520 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184601239 | University of Nv School of Medicine Multi Specialty Group Practice So | Pediatrics | 1701 W Charleston Blvd, #110, Las Vegas, NV 89102-2325 | 2005-12-29 |
| 1285193375 | Robert M Mercer | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, Las Vegas, NV 89102-2325 | 2019-03-18 |
| 1407343155 | Hui Feng | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, Las Vegas, NV 89102-2325 | 2018-04-18 |
| 1497250658 | Matthew Scott Carrea | General Practice | 1701 W Charleston Blvd, Las Vegas, NV 89102-2325 | 2018-03-28 |
| 1902332398 | Mariam Al-hamad | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, #400, Las Vegas, NV 89102-2325 | 2017-05-04 |
| 1942735808 | Tyler Paul Heeren | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, Suite 230, Las Vegas, NV 89102-2325 | 2017-04-27 |
| 1649704172 | Christian Nicholas Chan | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, #400, Las Vegas, NV 89102-2325 | 2017-04-11 |
| 1164955993 | Manvinder Singh Kumar | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, #490, Las Vegas, NV 89102-2325 | 2017-04-08 |
| 1376076232 | Katherine Rief | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, #230, Las Vegas, NV 89102-2325 | 2017-04-07 |
| 1710410766 | Michael Elias | Student in an Organized Health Care Education/Training Program | 1701 W Charleston Blvd, Las Vegas, NV 89102-2325 | 2017-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| 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 | ||||
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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.