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SHADOW MOUNTAIN DENTAL GROUP
NPI 1427238534
Dentist - General Practice in Las Vegas, NV

Active since November 06, 2007
6525 N DECATUR BLVD, SUITE 150, LAS VEGAS, NV 89131(702) 577-1941(702) 395-7813 Get Directions Write a Review

NPPES record last updated: November 7, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shadow Mountain Dental Group NPPES

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

SHADOW MOUNTAIN DENTAL GROUP (NPI 1427238534) is a healthcare organization registered as a general practice in Las Vegas, Nevada and active in the NPI registry since November 2007. The organization lists Lynda C Watanabe, Owner Doctor, as its authorized official.

NPPES Registry Identity

NPI1427238534
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameWATANABE SHADOW MOUNTAIN DENTAL GROUP, PROFESSIONAL CORPORATION
Location Address6525 N DECATUR BLVD, SUITE 150Las Vegas, NV 89131
Mailing Address2860 Michelle, 2nd FloorIrvine, CA 92606-1009 · (714) 508-3600 · Fax (714) 368-2092
Phone(702) 577-1941
Fax(702) 395-7813
Organization SubpartNo
Authorized OfficialLynda C WatanabeOwner Doctor · (702) 577-1941
Enumeration DateNovember 6, 2007
Last NPPES UpdateNovember 7, 2007
✔ NPI 1427238534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

6525 N DECATUR BLVD, Las Vegas, NV 89131
Open in Google Maps ↗

Other Names 1

Doing Business AsShadow Mountain Dental Group

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Humana.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 29D2263732

Shadow Mountain Dental Group · Las Vegas, NV
Expired · Jul 4, 2026
CLIA Number29D2263732
Laboratory TypePractitioner Other
Certificate Effective DateJuly 5, 2024
Certificate Expiration DateJuly 4, 2026
Laboratory DirectorAli Shahrestani
Laboratory Phone(702) 577-1941
Laboratory LocationShadow Mountain Dental Group6525 N Decatur Blvd, Suite 150, Las Vegas, NV 89131
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAKO H KARAKOZIAN D.D.S.
Dentist (General Practice)
6525 N DECATUR BLVD, SUITE 150
LAS VEGAS, NV 89131
Clark County (702) 577-1941
DR. ROMULO JOSEPH GUIDENG JR. DMD
Dentist (General Practice)
6525 N DECATUR BLVD, STE 150
LAS VEGAS, NV 89131
Clark County (702) 577-1941
DR. MEREDITH ANNE WOLF DMD
Dentist (General Practice)
6525 N DECATUR BLVD, SUITE 150
LAS VEGAS, NV 89131
Clark County (702) 577-1941
SYLVIA CATHERINE JOHNSON DMD
Dentist (General Practice)
6525 N DECATUR BLVD
LAS VEGAS, NV 89131
Clark County (702) 577-1941
DR. NICOLE K.I. FERNANDEZ
Dentist
6525 N DECATUR BLVD, SUITE 150
LAS VEGAS, NV 89131
Clark County (702) 577-1941

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 Watanabe Shadow Mountain Dental Group, Professional Corporation's NPI number?

The NPI number for Watanabe Shadow Mountain Dental Group, Professional Corporation is 1427238534. It was assigned to this organization in the NPPES registry on November 6, 2007. The provider is doing business as Shadow Mountain Dental Group.

Where is Watanabe Shadow Mountain Dental Group, Professional Corporation located?

Watanabe Shadow Mountain Dental Group, Professional Corporation is located at 6525 N Decatur Blvd Suite 150, Las Vegas, NV 89131. The listed phone number is (702) 577-1941.

What is Watanabe Shadow Mountain Dental Group, Professional Corporation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Watanabe Shadow Mountain Dental Group, Professional Corporation accept?

Health plans from Ambetter from Arizona Complete Health and Humana list Watanabe Shadow Mountain Dental Group, Professional Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Watanabe Shadow Mountain Dental Group, Professional Corporation was last updated on November 7, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.