Provider Demographics
NPI:1215077169
Name:HO, TIMOTHY NICHOLAS (DMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:NICHOLAS
Last Name:HO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11753 SAN ROSARITA CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6022
Mailing Address - Country:US
Mailing Address - Phone:954-646-9600
Mailing Address - Fax:
Practice Address - Street 1:11350 SOUTHERN HIGHLANDS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3291
Practice Address - Country:US
Practice Address - Phone:702-242-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17476122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist