# BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University of Nevada, Las Vegas School of Dental Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053414862
- **Authorized official:** MS. AMELIA YOLANDA MOLOCHE DELEGATED OFFICIAL (CREDENTIALING MANAGER)
- **Authorized official phone:** (702) 774-2661

## Contact information

- **Practice address:** 1700 W CHARLESTON BLVD BLDG A, LAS VEGAS, NV 89102-2335
- **Practice address phone:** (702) 774-2400
- **Practice address fax:** (702) 774-2499
- **Mailing address:** 1001 SHADOW LN \# MS 7413, LAS VEGAS, NV 89106-4124
- **Mailing address phone:** (702) 774-2661
- **Mailing address fax:** (702) 774-2610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 04/09/2020