NPI 1609481928 · live from the CMS NPI Registry
Mykel Anderson, DMD, MPH, MBA
Dentist, Orthodontics and Dentofacial Orthopedics in Henderson, NV. National Provider Identifier 1609481928, active.
NPI record
| NPI | 1609481928 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 256 E Lake Mead Pkwy, Henderson, NV 89015 |
| Practice phone | 702-703-5410 |
| Mailing address | 1350 Kelso Dunes Ave Apt 315, Henderson, NV 89014 |
| Enumerated | September 14, 2020 |
| Last updated | September 14, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | DDS104743 (CA) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 6978 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.