MEDICARE: A PLUS DENTAL GROUP 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	122300000X	Dentist

General Provider Information

NPI Number	:	1295252559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLUS DENTAL GROUP LLC

Provider Business Mailing Address
First Line	:	2285 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5100
Country	:	US
Telephone Number	:	702-522-9192
Fax Number	:

Provider Business Practice Location Address
First Line	:	4226 S DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8721
Country	:	US
Telephone Number	:	702-522-9192
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. LEILA KHOSSOOSI
Credential	:	DDS
Telephone Number	:	702-522-9192

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	08/28/2017

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Directions to “A PLUS DENTAL GROUP LLC ” Practice Location

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