Provider Demographics
NPI:1194586248
Name:NAVARRO, MARVELYN (RDH)
Entity type:Individual
Prefix:
First Name:MARVELYN
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CHARTAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-5140
Mailing Address - Country:US
Mailing Address - Phone:702-785-4367
Mailing Address - Fax:
Practice Address - Street 1:1930 VILLAGE CENTER CIR STE 3957
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6299
Practice Address - Country:US
Practice Address - Phone:714-292-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV102195124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist