| Lasting Smiles Dental Care | |
|
4011 Meadows Ln #101 Las Vegas NV 89107 | |
| (702) 259-5295 | |
| (702) 259-6595 |
| Full Name | Lasting Smiles Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 4011 Meadows Ln, Las Vegas, Nevada |
| Authorized Official Name and Position | Sharam Ghodsi (PRESIDENT) |
| Authorized Official Contact | 7028093762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lasting Smiles Dental Care 4011 Meadows Ln #101 Las Vegas NV 89107 Ph: (702) 259-5295 | Lasting Smiles Dental Care 4011 Meadows Ln #101 Las Vegas NV 89107 Ph: (702) 259-5295 |
| NPI Number | 1447336086 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 0143683771 |
|---|---|
| Medicare Enrollment ID | O20230830002461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447336086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | NV3185 (Nevada) | Primary |
| Provider Name | Sharam Ghodsi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1427283670 PECOS PAC ID: 1052774684 Enrollment ID: I20230830002749 |
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