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General NPI Number Information
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NPI Number | 1467827105
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Entity Type | Organization
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Legal Business Name | A PLUS DENTAL GROUP LLC
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 2285 E FLAMINGO RD 101
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City | LAS VEGAS
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State | NV
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Zip | 89119-5100
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Country | US
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Telephone | 702-522-9192
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Fax | 702-546-5679
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Provider Business Mailing Address
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Address Line | 2285 E FLAMINGO RD 101
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City | LAS VEGAS
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State | NV
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Zip | 89119-5100
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Country | US
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Telephone | 702-522-9192
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Fax | 702-546-5679
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Authorized Official
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Title or Position | DOCTOR/MANAGER
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Name | DR. LEILA KHOSSOOSI
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Credential | DDS
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Telephone | 702-522-9192
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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 | 6598
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-281
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6365
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License Number State | NV
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