Healthcare Provider Details

I. General information

NPI: 1922264027
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

169 N NELLIS BLVD
LAS VEGAS NV
89110-5320
US

IV. Provider business mailing address

169 N NELLIS BLVD
LAS VEGAS NV
89110-5320
US

V. Phone/Fax

Practice location:
  • Phone: 702-438-2188
  • Fax: 702-438-8424
Mailing address:
  • Phone: 702-438-2188
  • Fax: 702-438-8424

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