Healthcare Provider Details

I. General information

NPI: 1346406444
Provider Name (Legal Business Name): ARTISTIC ORTHODONTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 S RANCHO DR #4
LAS VEGAS NV
89106-3825
US

IV. Provider business mailing address

860 S RANCHO DR #4
LAS VEGAS NV
89106-3825
US

V. Phone/Fax

Practice location:
  • Phone: 702-878-0808
  • Fax: 702-870-2034
Mailing address:
  • Phone: 702-878-0808
  • Fax: 702-870-2034

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. FRASHAD ZAGHI
Title or Position: OWNER
Credential: DMD
Phone: 702-435-5015