FIFE DERMATOLOGY PC (NPI# 1598323362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598323362 |
| Entity Type | Organization |
| Organization Name | FIFE DERMATOLOGY PC |
| Practice Address |
2110 E Flamingo Rd # 213 Las Vegas NV 89119-5190 |
| Practice Telephone | 7022556647 |
| Practice Fax Number | 7029331444 |
| Mailing Telephone | 7022556647 |
| Mailing Fax Number | 7029331444 |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |
| Authorized Official Name | DOUGLAS JACKSON FIFE (PHYSICIAN) |
| Authorized Official Telephone | 7022556647 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Vivda Dermatology | Doing Business As Name - Organization |
| Vivida Dermatology | Doing Business As Name - Organization |
| Street Address |
2110 E FLAMINGO RD # 213 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-5190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | [email protected], 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407992217 | Daniel Taheri Md PC | Dermatology | 5731 S Fort Apache Rd Ste 130, Las Vegas, NV 89148-5666 | 2007-01-29 |
| 1083636369 | James Del Rosso | Dermatology | 9097 W Post Rd Ste 100, Las Vegas, NV 89148-2417 | 2006-07-24 |
| 1174923221 | F. Victor Rueckl Dermatology, Pllc | Dermatology | 8861 W Sahara Ave Ste 290, Las Vegas, NV 89117-4808 | 2014-08-26 |
| 1740516699 | Fife Dermatology, P.C. | Dermatology | 6460 Medical Center St, Ste 350, Las Vegas, NV 89148-2406 | 2009-10-28 |
| 1649505496 | Mac Lee Machan | Dermatology | 6460 Medical Center St Ste 350, Las Vegas, NV 89148-2423 | 2009-10-13 |
| 1972750370 | Grace Kyung Kim | Dermatology | 2615 Box Canyon Dr, Las Vegas, NV 89128-0450 | 2008-08-27 |
| 1730101023 | Douglas Thomas | Dermatology | 9097 W Post Rd, Suite 100, Las Vegas, NV 89148-2411 | 2006-07-24 |
| 1134147853 | Lucius Blanchard | Dermatology | 4488 S Pecos Rd, Las Vegas, NV 89121-5030 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821569138 | Fife Dermatology, P.C. | Dermatology | 1736 W. Horizon Ridge Parkway, Henderson, NV 89012 | 2018-12-13 |
| 1073820536 | Lauren Michelle Lee | Dermatology | 276 Kingsbury Grade Ste 101, Stateline, NV 89449-9804 | 2010-09-04 |
| 1063595924 | Martin E. Salm, M.d., Ltd. | Dermatology | 276 Kingsbury Grade, Suite 101, Stateline, NV 89449-5910 | 2006-10-23 |
| 1003905001 | Skin Cancer and Dermatology Institute | Dermatology | 3950 Gs Richards Blvd, Carson City, NV 89703-8457 | 2006-10-11 |
| 1740633015 | Mountain West Derm - Blackhart Pllc | Dermatology | 3950 Gs Richards Blvd, Carson City, NV 89703-8457 | 2016-07-21 |
| 1780856559 | Martin E. Salm, M.d., Ltd | Dermatology | 276 Kingsbury Grade, Suite 101, Stateline, NV 89449-5910 | 2008-04-01 |
| 1780852368 | Clemmensen, Adams, & Tack Psc | Dermatology | 1100 S Carson St, Carson City, NV 89701-5232 | 2008-02-15 |
| 1841214632 | Ruth Elizabeth Adams | Dermatology | 1100 S Carson St, Carson Dematology, Carson City, NV 89701-5232 | 2006-07-26 |
| 1053314708 | Dan E Rowe | Dermatology | 640 W Moana Ln, Reno, NV 89509-4857 | 2005-05-24 |
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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.