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Organization

PARADISE LV NIELSON PDC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAXON DOWNING (CREDENTIALING SPECIALIST)
(801) 305-3460
Entity
Organization

Contact information

Practice address
2458 E RUSSELL RD STE B, LAS VEGAS, NV 89120-2475
(702) 798-4595
Mailing address
727 E UTAH VALLEY DR, AMERICAN FORK, UT 84003-3345
(801) 305-3460

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/15/2025
Last updated
10/15/2025
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