Provider Demographics
NPI:1699912097
Name:AAA DENTAL INSURANCE PROVIDER, LLC
Entity type:Organization
Organization Name:AAA DENTAL INSURANCE PROVIDER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-309-4600
Mailing Address - Street 1:8855 W FLAMINGO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8706
Mailing Address - Country:US
Mailing Address - Phone:702-309-4600
Mailing Address - Fax:702-309-2771
Practice Address - Street 1:8855 W FLAMINGO RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8706
Practice Address - Country:US
Practice Address - Phone:702-309-4600
Practice Address - Fax:702-309-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV45291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty