MEDICARE: NU SMILES2, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1063170082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU SMILES2, LLC

Provider Business Mailing Address
First Line	:	2810 W HORIZON RIDGE PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4593
Country	:	US
Telephone Number	:	702-848-2525
Fax Number	:	702-848-2333

Provider Business Practice Location Address
First Line	:	5905 S EASTERN AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3130
Country	:	US
Telephone Number	:	702-848-2525
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. CINDY NOU
Credential	:	DMD
Telephone Number	:	702-848-2525

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	12/07/2021

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Directions to “NU SMILES2, LLC ” Practice Location

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