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General NPI Number Information
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NPI Number | 1013807981
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Entity Type | Organization
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Legal Business Name | SUMMERHILLS NIELSON PDC PLLC
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2261 N RAMPART BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89128-7640
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Country | US
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Telephone | 702-363-8655
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Fax |
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Provider Business Mailing Address
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Address Line | 727 E UTAH VALLEY DR
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City | AMERICAN FORK
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State | UT
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Zip | 84003-3345
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Country | US
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Telephone | 801-691-1701
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MARK CHRISTENSEN
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Credential |
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Telephone | 801-691-1701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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