Organization · Type 2 NPI

Centennial LV LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Las Vegas, NV

NPI number 1639350804 Active

Practice location

8775 W Deer Springs Way
Las Vegas, NV 89149-0416

Call (702) 395-2488 Map

Fax (702) 645-5007

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1639350804
Entity type: Organization (Type 2)
Issued: Nov 16, 2007
Last updated: Dec 29, 2025
Status: Active

Other names

<unavail>
Centennial Dialysis Center · doing business as
Centennial Dialysis Center · doing business as

Authorized official

Samuel Wey
VP, Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639350804

Centennial LV LLC's National Provider Identifier is 1639350804, issued on Nov 16, 2007. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Las Vegas, NV. The record was last updated on Dec 29, 2025.