MEDICARE: HYLO PARK DENTAL PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1083435366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYLO PARK DENTAL PLLC

Provider Business Mailing Address
First Line	:	7380 EDNA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2902
Country	:	US
Telephone Number	:	702-883-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	3880 W LAKE MEAD BLVD STE 100
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-5201
Country	:	US
Telephone Number	:	702-626-0526
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. KHURRAM FAHIM
Credential	:	DMD
Telephone Number	:	702-883-4345

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

Similar Medicare Providers

1144503640 — DR. JON-CHRISTOPHER ROSALES DMD
Practice Location Address:

3880 W LAKE MEAD BLVD STE 100
NORTH LAS VEGAS, NV
89032-5201

Practice Phone: 702-399-8888
Practice Fax:

1578421095 — MEREDITH PRICE
Practice Location Address:

2840 E FLAMINGO RD STE B
LAS VEGAS, NV
89121-5201

Practice Phone: 937-952-6379
Practice Fax:

1619673548 — VALLEY HOME CARE
Practice Location Address:

2840 E FLAMINGO RD STE D
LAS VEGAS, NV
89121-5201

Practice Phone: 702-366-3513
Practice Fax:

1457436503 — MS. RITA PICKERING MFT
Practice Location Address:

2840 E FLAMINGO RD STE A
LAS VEGAS, NV
89121-5201

Practice Phone: 702-732-0153
Practice Fax: 702-732-0917

1023155900 — MS. RONETTA J. YATES M.S., M.F.T.
Practice Location Address:

2840 E FLAMINGO RD STE A
LAS VEGAS, NV
89121-5201

Practice Phone: 702-292-8716
Practice Fax: 877-639-6606

1629385604 — JODY MARSHALL LCPC, LCADC-S
Practice Location Address:

2840 E FLAMINGO RD STE A
LAS VEGAS, NV
89121-5201

Practice Phone: 702-217-5639
Practice Fax: 702-441-1262

Directions to “HYLO PARK DENTAL PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.