MEDICARE: LARRY ONEAL STAPLES DDS

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	133766	UT
2	122300000X	Dentist	4667	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4667	OTHER	NV	NEVADA STATE BOARD OF DENTISTRY

General Provider Information

NPI Number	:	1568577351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY ONEAL STAPLES DDS

Provider Business Mailing Address
First Line	:	2345 E. CENTENNIAL PARKWAY
Second Line	:	110
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-5605
Country	:	US
Telephone Number	:	702-991-0404
Fax Number	:	702-991-0402

Provider Business Practice Location Address
First Line	:	2345 E. CENTENNIAL PARKWAY
Second Line	:	110
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-5605
Country	:	US
Telephone Number	:	702-991-0404
Fax Number	:	702-991-0402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	06/14/2026

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Directions to “ LARRY ONEAL STAPLES DDS” Practice Location

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