Provider Demographics
NPI:1871918441
Name:CAPSTONE DENTAL
Entity type:Organization
Organization Name:CAPSTONE DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:INRI
Authorized Official - Middle Name:T
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-990-6926
Mailing Address - Street 1:62 N PECOS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7335
Mailing Address - Country:US
Mailing Address - Phone:702-990-6926
Mailing Address - Fax:702-990-6928
Practice Address - Street 1:62 N PECOS RD
Practice Address - Street 2:SUITE A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7335
Practice Address - Country:US
Practice Address - Phone:702-990-6926
Practice Address - Fax:702-990-6928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV42931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty