JENS WILSON (NPI# 1568089076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568089076 |
| Entity Type | Individual |
| Full Name | JENS WILSON |
| Credential | DMD |
| Practice Address |
101 Shadow Ln Las Vegas NV 89106-4301 |
| Mailing Address |
3846 Waynesvill St Las Vegas NV 89122-4732 |
| Practice Telephone | 7027742416 |
| Mailing Telephone | 4354594457 |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
LL-541-20 | NV | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3846 Waynesvill St, Las Vegas, NV 891224732 | 4354594457 |
| Street Address |
101 SHADOW LN |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| 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 |
|---|---|---|---|---|
| 1942840723 | Bella Children's Dental Care LLC | Dentist | 560 N Nellis Blvd Ste E2, Las Vegas, NV 89110-5370 | 2020-01-09 |
| 1649760257 | Sorenson Pediatric Dentistry Pllc | Dentist | 5745 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5623 | 2018-05-18 |
| 1609377373 | H&b Pediatric Dentistry LLC | Dentist | 8520 Blue Diamond Rd Ste 130, Las Vegas, NV 89178-9297 | 2018-02-27 |
| 1528430790 | Absolute Dental & Orthodontics Prada, Pllc | Dentist | 8380 W Cheyenne Ave Ste 104, Las Vegas, NV 89129-2175 | 2015-10-27 |
| 1083090864 | Chandler Hyer | Dentist | 712 Jacobs Ladder Pl, Las Vegas, NV 89138-7540 | 2015-08-04 |
| 1396125415 | Dawn Mcclellan, Dds, Ms, A Professional Corporation | Dentist | 3603 Las Vegas Blvd N Ste 120, Las Vegas, NV 89115-0591 | 2015-06-03 |
| 1942693403 | Lindsay Row | Dentist | 653 N Town Center Dr Ste 606, Las Vegas, NV 89144-0520 | 2015-03-09 |
| 1467842302 | Adventure Smiles | Dentist | 8995 W Flamingo Rd, Suite 100, Las Vegas, NV 89147-0441 | 2015-01-30 |
| 1740684430 | Waggoner & Associates PC | Dentist | 2381b Renaissance Dr, Las Vegas, NV 89119-6498 | 2014-10-09 |
| 1518248590 | Dr. B's Children's Dentistry LLC | Dentist | 5705 Centennial Center Blvd Ste 140, Las Vegas, NV 89149-7129 | 2011-09-02 |
| Find all providers in LAS VEGAS | ||||
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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.