MEDICARE: ALIGN BRACES

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1013442086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIGN BRACES

Provider Business Mailing Address
First Line	:	4250 SIMMONS ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0768
Country	:	US
Telephone Number	:	702-242-5251
Fax Number	:	702-243-2893

Provider Business Practice Location Address
First Line	:	6127 S RAINBOW BLVD STE 101A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3256
Country	:	US
Telephone Number	:	702-242-5251
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	JAHNAVI RAO
Credential	:	MD, DDS
Telephone Number	:	702-242-5251

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	04/26/2017

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Directions to “ALIGN BRACES ” Practice Location

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