RESIDENTAL – NPI #1891536249
Clinic/Center

RESIDENTAL is an AHC clinic located in NORTH LAS VEGAS, NV. NPPES has assigned the NPI number 1891536249 to RESIDENTAL on May 31, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was last updated on Jun 14, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RESIDENTAL below.

NPI Profile for
RESIDENTAL

NPI Number
1891536249
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RESIDENTAL
Primary location
5833 FOX HAIR STREET
NORTH LAS VEGAS, NV 89081
Phone: (661) 886-3583 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
STEFANIE BERTRAM
OWNER
Phone: (661) 886-3583
Updated
Certification Date
Jun 14, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.