Healthcare Provider Details

I. General information

NPI: 1558279935
Provider Name (Legal Business Name): AJK DENTAL ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HUMBOLDT AVENUE SUITE A
WELLS NV
89835
US

IV. Provider business mailing address

732 S 6TH ST STE V
LAS VEGAS NV
89101-6948
US

V. Phone/Fax

Practice location:
  • Phone: 317-385-3305
  • Fax:
Mailing address:
  • Phone: 317-385-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW KASKIE
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 317-385-3305