MEDICARE: THRIVE DENTAL GROUP INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	122300000X	Dentist

General Provider Information

NPI Number	:	1003198417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE DENTAL GROUP INC.

Provider Business Mailing Address
First Line	:	7310 SMOKE RANCH RD STE R
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0260
Country	:	US
Telephone Number	:	702-480-8187
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 SMOKE RANCH RD STE R
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0260
Country	:	US
Telephone Number	:	702-877-9977
Fax Number	:	702-899-5501

Authorized Official
Title or Position	:	OWNER
Name	:	GILBERTO SUAREZ JR.
Credential	:	OWNER
Telephone Number	:	702-877-9977

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	01/06/2026

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