Provider Demographics
NPI:1528268976
Name:CENTER FOR SPINE & SPECIAL SURGERY
Entity type:Organization
Organization Name:CENTER FOR SPINE & SPECIAL SURGERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASWINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-839-4810
Mailing Address - Street 1:7140 SMOKE RANCH RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:702-320-8111
Mailing Address - Fax:702-851-1532
Practice Address - Street 1:3175 ST. ROSE PARKWAY
Practice Address - Street 2:SUITE 121
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-320-8111
Practice Address - Fax:702-851-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC14004521123339261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019663Medicaid
NVV39882Medicare UPIN