SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP - NPI 1063309755

Q: What is Shadow Creek Children's Dentistry And Orthodontics General Partnership's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

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About Shadow Creek Children's Dentistry And Orthodontics General Partnership NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP (NPI 1063309755), doing business as Shadow Creek Children's Dentistry And Orthodontics, is a healthcare organization registered as a pediatric dentistry in North Las Vegas, Nevada and active in the NPI registry since June 2025. The organization lists Ryan Jolley, Partner, as its authorized official.

NPPES Registry Identity

NPI1063309755

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameSHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS GENERAL PARTNERSHIP

Location Address3410 E CENTENNIAL PKWY STE 110North Las Vegas, NV 89081-5627

Mailing Address3196 S Maryland Pkwy Ste 307Las Vegas, NV 89109-2314

Phone(702) 701-2563

Organization SubpartNo

Authorized OfficialRyan JolleyPartner · (702) 701-2563

Enumeration DateJune 23, 2025

NPPES CertifiedJune 23, 2025

✔ NPI 1063309755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X

3410 E CENTENNIAL PKWY STE 110, North Las Vegas, NV 89081

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Other Names 1

Doing Business AsShadow Creek Children's Dentistry And Orthodontics

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadow Creek Children's Dentistry And Orthodontics General Partnership's NPI number?

The NPI number for Shadow Creek Children's Dentistry And Orthodontics General Partnership is 1063309755. It was assigned to this organization in the NPPES registry on June 23, 2025. The provider is doing business as Shadow Creek Children's Dentistry and Orthodontics.

Where is Shadow Creek Children's Dentistry And Orthodontics General Partnership located?

Shadow Creek Children's Dentistry And Orthodontics General Partnership is located at 3410 E Centennial Pkwy Ste 110, North Las Vegas, NV 89081. The listed phone number is (702) 701-2563.

What is Shadow Creek Children's Dentistry And Orthodontics General Partnership's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Shadow Creek Children's Dentistry And Orthodontics General Partnership was last updated on June 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.