Healthcare Provider Details

I. General information

NPI: 1336004886
Provider Name (Legal Business Name): REDESIGN DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 S EASTERN AVE STE B
LAS VEGAS NV
89123-2861
US

IV. Provider business mailing address

8440 S EASTERN AVE STE B
LAS VEGAS NV
89123-2861
US

V. Phone/Fax

Practice location:
  • Phone: 702-451-9111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EDUARDO DELAROSA PAIS III
Title or Position: PRESIDENT
Credential: DMD
Phone: 702-504-1773