MEDICARE: JOHN C GRIFFITHS DDS MDS A PROFESSIONAL CORPORATION

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1952188518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN C GRIFFITHS DDS MDS A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	8710 W CHARLESTON BLVD STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5468
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4240 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-2387
Country	:	US
Telephone Number	:	702-710-8091
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN C GRIFFITHS
Credential	:	DDS
Telephone Number	:	702-256-7846

Provider Enumeration Date	:	09/08/2023
Last Update Date	:	09/08/2023

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