=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598396236
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAJAND DENTAL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2020
-----------------------------------------------------
Last Update Date | 01/31/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8525 BLUE DIAMOND ROAD SUITE #110
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-660-2646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7104 PLUSHSTONE ST
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89148-3881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-328-1564
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. NAWEED NAJAND
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 702-328-1564
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------