BACCHUS PC – NPI #1134628480
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

BACCHUS PC is a provider located in HENDERSON, NV. NPPES has assigned the NPI number 1134628480 to BACCHUS PC on February 01, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI Registry, there are 5 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine. Please note, simply having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Apr 01, 2026. 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 BACCHUS PC below.

NPI Profile for
BACCHUS PC

NPI Number
1134628480
Enumeration Date

(more than 8 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
BACCHUS PC
Primary location
880 SEVEN HILLS DR STE 140
HENDERSON, NV 89052-4372
Phone: (702) 844-4840 Fax: (702) 844-4843
5 Other location(s):
2831 Business Park Ct Ste A
Las Vegas, NV 89128-9000
Phone: (702) 844-4848
Fax: (702) 844-4849
348 N Nellis Blvd Ste F
Las Vegas, NV 89110-5313
Phone: (702) 910-3950
9280 W Sunset Rd Ste 200
Las Vegas, NV 89148-4861
Phone: (702) 844-4846
Fax: (702) 844-4847
340 Falcon Ridge Pkwy Ste 201
Mesquite, NV 89027-8851
Phone: (702) 979-5966
Fax: (775) 231-8003
360 S Lola Ln Bldg B
Pahrump, NV 89048-0884
Phone: (775) 505-0810
Fax: (775) 505-0811
Mailing address
2370 CORPORATE CIR STE 300
HENDERSON, NV 89074-7760
Phone: (702) 910-3950 Fax: (702) 786-6650
Organization Subpart
No
Authorized Official
BEVERLY DENDARY
CREDENTIALING MANAGER
Phone: (702) 910-3950
Updated
Certification Date
Apr 01, 2026

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.

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.