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General NPI Number Information
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NPI Number | 1043729171
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Entity Type | Organization
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Legal Business Name | NADER AFSHARI DDS A DENTAL VENTURE INC
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 4161 S EASTERN AVE STE E8
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City | LAS VEGAS
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State | NV
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Zip | 89119-5425
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Country | US
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Telephone | 818-274-2215
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Fax | 702-233-1250
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Provider Business Mailing Address
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Address Line | 4161 S EASTERN AVE STE E8
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City | LAS VEGAS
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State | NV
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Zip | 89119-5425
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Country | US
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Telephone | 702-233-1222
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Fax | 702-233-1250
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Authorized Official
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Title or Position | OWNER /DENTIST
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Name | NADER AFSHARI
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Credential | DDS
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Telephone | 818-929-9284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3179
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License Number State | NV
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