MEDICARE: ABSOLUTE DENTAL LAKE MEAD, LLP

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	4509T	NV

General Provider Information

NPI Number	:	1104912831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE DENTAL LAKE MEAD, LLP

Provider Business Mailing Address
First Line	:	2301 E LAKE MEAD BLVD
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89030-7137
Country	:	US
Telephone Number	:	702-649-9333
Fax Number	:	702-639-0579

Provider Business Practice Location Address
First Line	:	2301 E LAKE MEAD BLVD
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89030-7137
Country	:	US
Telephone Number	:	702-649-9333
Fax Number	:	702-639-0579

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BENNY KOHANTEB
Credential	:
Telephone Number	:	702-218-2713

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1023186095 — DR. JEREMY T WILSON DMD
Practice Location Address:

2301 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
89030-7137

Practice Phone: 702-331-8338
Practice Fax: 702-639-0579

1417086661 — DAWNA THIEN PHAN D.D.S.
Practice Location Address:

2301 E LAKE MEAD BLVD
N LAS VEGAS, NV
89030-7137

Practice Phone: 702-331-8338
Practice Fax: 702-639-0579

1124238662 — DR. VIVI VAN DANG-ROBERTS I DDS
Practice Location Address:

2217 E LAKE MEAD BLVD
NORTH LAS VEGAS, NV
89030-7137

Practice Phone: 702-641-5888
Practice Fax: 702-633-0099

1689838005 — DR. NISCHAL NATHA DMD
Practice Location Address:

2217 E LAKE MEAD BLVD # A
NORTH LAS VEGAS, NV
89030-7137

Practice Phone: 702-641-5888
Practice Fax: 702-633-0099

1447406103 — ARTISTIC ORTHODONTICS
Practice Location Address:

2301 E LAKE MEAD BLVD
N LAS VEGAS, NV
89030-7137

Practice Phone: 702-641-5888
Practice Fax: 702-639-0579

Directions to “ABSOLUTE DENTAL LAKE MEAD, LLP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.