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1154457851 NPI number — KEVIN SOMMER WARTHAN DDS

NPI Number: 1154457851
Health Care Provider/Practitioner: KEVIN SOMMER WARTHAN DDS

Information about “1154457851” NPI (KEVIN SOMMER WARTHAN DDS) exists in 1154457851 in HTML format HTML  |  1154457851 in plain Text format TXT  |  1154457851 in PDF (Portable Document Format) PDF  |  1154457851 in an XML format XML  formats.

NPI Number : 1154457851 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154457851",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WARTHAN",
    "FirstName": "KEVIN",
    "MiddleName": "SOMMER",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2505 ANTHEM VILLAGE DR # E147",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HENDERSON",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89052-5505",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "855-992-9935",
    "MailingAddressFaxNumber": "702-992-9935",
    "FirstLinePracticeLocationAddress": "2505 ANTHEM VILLAGE DR # E147",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HENDERSON",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89052-5505",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-992-9935",
    "PracticeLocationAddressFaxNumber": "702-992-9935",
    "EnumerationDate": "02/26/2007",
    "LastUpdateDate": "03/04/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "4158",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "37060",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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