Healthcare Provider Details

I. General information

NPI: 1730343245
Provider Name (Legal Business Name): MAI MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 ARROYO CROSSING PKWY STE 100
LAS VEGAS NV
89113
US

IV. Provider business mailing address

7300 ARROYO CROSSING PKWY STE 100
LAS VEGAS NV
89113
US

V. Phone/Fax

Practice location:
  • Phone: 702-656-7846
  • Fax: 702-656-7846
Mailing address:
  • Phone: 702-656-7846
  • Fax: 702-656-7846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-155
License Number StateNV

VIII. Authorized Official

Name: KIM MAI
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 702-656-7846