Provider Demographics
NPI:1588960439
Name:ARTISTIC ORTHODONTICS- MEADOWS
Entity type:Organization
Organization Name:ARTISTIC ORTHODONTICS- MEADOWS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-435-5015
Mailing Address - Street 1:8370 W CHEYENNE AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-2174
Mailing Address - Country:US
Mailing Address - Phone:702-877-2200
Mailing Address - Fax:702-395-7246
Practice Address - Street 1:4300 MEADOWS LN
Practice Address - Street 2:1350
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3004
Practice Address - Country:US
Practice Address - Phone:702-472-7320
Practice Address - Fax:702-258-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS3-2001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty