SANJAY KANDOTH MD PC (NPI# 1558924613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558924613 |
| Entity Type | Organization |
| Organization Name | SANJAY KANDOTH MD PC |
| Practice Address |
1701 N Green Valley Pkwy Ste 10a Henderson NV 89074-5991 |
| Mailing Address |
3061 S Maryland Pkwy Ste 101 Las Vegas NV 89109-6226 |
| Practice Telephone | 7022545437 |
| Practice Fax Number | 7022547354 |
| Mailing Telephone | 7022545437 |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | DR. SANJAY W KANDOTH (PRESIDENT/ OWNER) |
| Authorized Official Telephone | 7022545437 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sunrise Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255622577 | Sanjay Kandoth Md PC | Pediatrics | 7875 S Rainbow Blvd, Suite 102, Las Vegas, NV 89139-6469 | 2011-04-20 |
| 1487824223 | Sanjay Kandoth Md PC | Pediatrics | 3061 S Maryland Pkwy Ste 101, Las Vegas, NV 89109-6226 | 2008-03-07 |
| 1558806570 | Sanjay Kandoth Md PC | Pediatrics | 7200 Smoke Ranch Rd, Suite 150, Las Vegas, NV 89128-1115 | 2016-12-29 |
| Street Address |
1701 N GREEN VALLEY PKWY STE 10A |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074-5991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144739707 | Dignity Health Medical Group Nevada, LLC | Nurse Practitioner | 1701 N Green Valley Pkwy Ste 10a, Henderson, NV 89074-5991 | 2017-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028106 | Harold Zilberman, Md, Chartered | Pediatrics | 880 Seven Hills Dr Ste 100, Henderson, NV 89052-4372 | 2019-08-12 |
| 1740747542 | Payton Cerda | Pediatrics | 2510 W Horizon Ridge Pkwy Ste 130, Henderson, NV 89052-1600 | 2019-02-27 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| 1679852891 | Jung Y. Hahr | Pediatrics | 969 Wagner Valley St, Henderson, NV 89052-5064 | 2011-08-04 |
| 1174755276 | Placida Martinez | Pediatrics | 247 Clemson St, Henderson, NV 89074-5484 | 2009-08-22 |
| 1306029830 | Mdfamily Medical Group | Pediatrics | 152 Zeb Robinson Rd, Henderson, NC 27537-3577 | 2007-12-06 |
| 1346374238 | Susan R Fernandez PC | Pediatrics | 2621 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052-2895 | 2007-03-15 |
| 1750422481 | Jagannath S. Surpure, M.d.p.c. | Pediatrics | 1600 W Sunset Rd, Suite A, Henderson, NV 89014-2654 | 2007-02-08 |
| 1184774093 | James Allen Wayne Jr. | Pediatrics | 451 Ruin Creek Rd Ste 101, Henderson, NC 27536-5920 | 2007-01-11 |
| 1982763108 | Hesham Sirsy Md Ltd | Pediatrics | 10950 S Eastern Ave, #100, Henderson, NV 89052-4970 | 2006-12-06 |
| 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.