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General NPI Number Information
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NPI Number | 1184080996
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Entity Type | Organization
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Legal Business Name | FLAMINGO DENTAL SLEEP SOLUTIONS INC
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Dates
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Enumeration Date | 01/08/2016
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 4045 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-5101
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Country | US
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Telephone | 702-892-9878
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Fax |
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Provider Business Mailing Address
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Address Line | 4045 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-5101
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Country | US
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Telephone | 702-892-9878
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON J HSIEH
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Credential | DDS
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Telephone | 702-892-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5037
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 5037
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License Number State | NV
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