# MODERN DENTAL SPECIALIST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MODERN DENTAL SPECIALISTS, LLC
- **Other names:** Modern Dental, Modern Dental Specialists
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487344032
- **Legal business name:** MODERN DENTAL SPECIALISTS, LLC
- **Authorized official:** ANASTASIA SAVCIC (HR)
- **Authorized official phone:** (702) 449-2643

## Contact information

- **Practice address:** 2560 S MARYLAND PKWY STE 5&6, LAS VEGAS, NV 89109-1695
- **Practice address phone:** (702) 200-9000
- **Mailing address:** 4618 MEADOWS LN, LAS VEGAS, NV 89107-2956
- **Mailing address phone:** (702) 623-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 05/08/2023
- **Last updated:** 05/08/2023