Healthcare Provider Details

I. General information

NPI: 1851649768
Provider Name (Legal Business Name): ARASH BAKHAJ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4492 S PECOS RD
LAS VEGAS NV
89121-5030
US

IV. Provider business mailing address

618 CERVANTES DR
HENDERSON NV
89014-4023
US

V. Phone/Fax

Practice location:
  • Phone: 702-701-7999
  • Fax: 702-722-2277
Mailing address:
  • Phone: 646-592-5597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-275
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: