Healthcare Provider Details

I. General information

NPI: 1972690030
Provider Name (Legal Business Name): ARTISTIC ORTHODONTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 W CHEYENNE AVE 102
LAS VEGAS NV
89129-8405
US

IV. Provider business mailing address

8380 W CHEYENNE AVE 102
LAS VEGAS NV
89129-8405
US

V. Phone/Fax

Practice location:
  • Phone: 702-388-8989
  • Fax:
Mailing address:
  • Phone: 702-388-8989
  • Fax:

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: DMD
Phone: 702-218-2713