ELLSWORTH COX PEDIATRIC DENTISTRY LLC (NPI# 1417041146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417041146 |
| Entity Type | Organization |
| Organization Name | ELLSWORTH COX PEDIATRIC DENTISTRY LLC |
| Other Organization Name | ANTHEM PEDIATRIC DENTISTRY |
| Practice Address |
2843 Saint Rose Pkwy #100 Henderson NV 89052-4813 |
| Practice Telephone | 7025315437 |
| Practice Fax Number | 7026163565 |
| Mailing Telephone | 7025315437 |
| Mailing Fax Number | 7026163565 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-11-12 |
| Authorized Official Name | MRS. DIANA B. MENDOZA (OFFICE MANAGER) |
| Authorized Official Telephone | 7024595437 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3696 | NV | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
4341 | NV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | STATE LICENSE NUMBER | 4341 | 01 |
| NV | STATE LICENSE NUMBER | 3696 | 01 |
| Other Name | Type Code |
|---|---|
| Anthem Pediatric Dentistry | Doing Business As Name - Organization |
| Street Address |
2843 SAINT ROSE PKWY #100 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-4813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467417501 | Jeffrey Albert Cox | Dentist | 2843 Saint Rose Pkwy, Suite 100, Henderson, NV 89052-4806 | 2006-04-20 |
| 1790967818 | Marsha A. Folayan | Internal Medicine | 2843 Saint Rose Pkwy, #110, Henderson, NV 89052-4813 | 2007-11-30 |
| 1700834595 | Maria Lao | Internal Medicine | 2843 Saint Rose Pkwy, 110, Henderson, NV 89052-4813 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326537028 | Henderson Pediatric Dentistry PC | Dentist | 390 N Stephanie St Ste 104, Henderson, NV 89014-8029 | 2018-05-08 |
| 1457703290 | Wesley Archer | Dentist | 10400 S Eastern Ave, Henderson, NV 89052-3957 | 2016-07-05 |
| 1962843961 | Manny Rapp | Dentist | 1701 N. Green Valley Pkwy #8e, Henderson, NV 89074 | 2013-07-08 |
| 1699074112 | Rhonda L Kearney, Dds, Ms, Pllc | Dentist | 451 Ruin Creek Rd., 205, Henderson, NC 27536-0000 | 2011-03-23 |
| 1740485846 | Rhonda Louise Kearney | Dentist | 451 Ruin Creek Rd Ste 205, Henderson, NC 27536-5920 | 2007-06-19 |
| 1871702076 | Mark Clayton Peterson | Dentist | 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 | 2007-05-22 |
| 1003939810 | Daniel William Sims Professional Corporation | Dentist | 375 N Stephanie St Bldg 6, Suite 611, Henderson, NV 89014-8771 | 2007-04-08 |
| 1841392172 | Chad W. Ellsworth | Dentist | 2843 St. Rose Pkwy, Suite 100, Henderson, NV 89052 | 2006-09-05 |
| 1740391465 | Laurence Jay Levine | Dentist | 2610 W Horizon Ridge Pkwy Ste 202, Henderson, NV 89052-2870 | 2006-08-31 |
| 1912924820 | Adaven Childrens Dentistry | Dentist | 1701 N Green Valley Parkway, #8e, Henderson, NV 89074 | 2006-07-16 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.