MEDICARE: DR. MICHAEL IRWIN RIPS DDS

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	2944	NV

General Provider Information

NPI Number	:	1306873047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL IRWIN RIPS DDS

Provider Business Mailing Address
First Line	:	1001 SHADOW LANE
Second Line	:	204G
City	:	LAS VEGAS
State	:	NV
Zip	:	89106
Country	:	US
Telephone Number	:	702-774-2816
Fax Number	:	702-774-2811

Provider Business Practice Location Address
First Line	:	1700 W. CHARLESTON BLVD.
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108
Country	:	US
Telephone Number	:	702-774-2816
Fax Number	:	702-774-2811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	11/12/2008

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