Provider Demographics
NPI:1306258157
Name:DENTICE, JOE WILLIAM (MS)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:WILLIAM
Last Name:DENTICE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 S EASTERN AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2810
Mailing Address - Country:US
Mailing Address - Phone:702-325-3121
Mailing Address - Fax:
Practice Address - Street 1:8565 S EASTERN AVE STE 116
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2810
Practice Address - Country:US
Practice Address - Phone:702-325-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health