Provider Demographics
NPI:1215110242
Name:CUTTER, JI AE (DMD)
Entity type:Individual
Prefix:MRS
First Name:JI
Middle Name:AE
Last Name:CUTTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 SPRING MOUNTAIN RD #3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-220-8488
Mailing Address - Fax:702-476-6573
Practice Address - Street 1:6376 SPRING MOUNTAIN RD #3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-220-8488
Practice Address - Fax:702-476-6573
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV55781223G0001X
UT6647229-99221223G0001X
TX275441223G0001X
CA1001681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice