Healthcare Provider Details

I. General information

NPI: 1326564725
Provider Name (Legal Business Name): SUNRISE ORTHODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3196 S MARYLAND PKWY STE 307
LAS VEGAS NV
89109-2314
US

IV. Provider business mailing address

7090 N DURANGO DR STE 120
LAS VEGAS NV
89149-4495
US

V. Phone/Fax

Practice location:
  • Phone: 702-629-5695
  • Fax: 702-645-6793
Mailing address:
  • Phone: 702-645-5100
  • Fax: 702-645-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN ELDON CHAMBERLAIN
Title or Position: OWNER/OPERATOR
Credential: DDS MDS
Phone: 702-645-5100