Healthcare Provider Details

I. General information

NPI: 1003198417
Provider Name (Legal Business Name): THRIVE DENTAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 SMOKE RANCH RD STE R
LAS VEGAS NV
89128-0260
US

IV. Provider business mailing address

7310 SMOKE RANCH RD STE R
LAS VEGAS NV
89128-0260
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-9977
  • Fax: 702-899-5501
Mailing address:
  • Phone: 702-480-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: GILBERTO SUAREZ JR.
Title or Position: OWNER
Credential: OWNER
Phone: 702-877-9977