Provider Demographics
NPI:1053580332
Name:ADVANCED AESTHETIC PLASTIC SURGERY, LTD
Entity type:Organization
Organization Name:ADVANCED AESTHETIC PLASTIC SURGERY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-826-4477
Mailing Address - Street 1:10755 DOUBLE R BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8956
Mailing Address - Country:US
Mailing Address - Phone:775-826-4477
Mailing Address - Fax:775-826-4436
Practice Address - Street 1:10755 DOUBLE R BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8956
Practice Address - Country:US
Practice Address - Phone:775-826-4477
Practice Address - Fax:775-826-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36308Medicare UPIN