MEDICARE: S1 RCT 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1699587519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S1 RCT PLLC

Provider Business Mailing Address
First Line	:	2510 WIGWAM PKWY STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-263-2000
Fax Number	:	702-263-3036

Provider Business Practice Location Address
First Line	:	2510 WIGWAM PKWY STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-263-2000
Fax Number	:	702-263-3036

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN H SIMON
Credential	:	DDS
Telephone Number	:	702-263-2000

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/27/2025

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