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LONE MOUNTAIN FAMILY DENTAL NPI 1366811747


NPI Information

NPI: 1366811747
Provider Name: LONE MOUNTAIN FAMILY DENTAL

Former Legal Business Name: LONE MOUNTAIN DENTAL

Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
4818 W LONE MOUNTAIN RD
LAS VEGAS, NV
ZIP 89130
Phone: (702) 655-9533
Get Directions

LONE MOUNTAIN FAMILY DENTAL is a preferred provider organization in Las Vegas, NV. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. LONE MOUNTAIN FAMILY DENTAL NPI is 1366811747. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Lone Mountain Dental.

The provider's business location address is:

4818 W LONE MOUNTAIN RD
LAS VEGAS, NV
ZIP 89130-239
Phone: (702) 655-9533
Fax: (702) 655-9565

The provider's authorized official is Joshua David Etman .
The authorized official title is President/ Doctor and has the following contact phone number (702) 655-9533.

The enumeration date for this NPI number is 9/16/2015 and was last updated on 9/16/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305R00000XPreferred Provider Organization6547NEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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