MEDICARE: CHILDRENS SPECIALISTS OF LAS VEGAS

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1821823188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS SPECIALISTS OF LAS VEGAS

Provider Business Mailing Address
First Line	:	3585 S TOWN CENTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3019
Country	:	US
Telephone Number	:	702-979-3090
Fax Number	:

Provider Business Practice Location Address
First Line	:	3585 S TOWN CENTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3019
Country	:	US
Telephone Number	:	702-979-3090
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHANDLER HYER
Credential	:	DMD
Telephone Number	:	702-606-4094

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	09/30/2024

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