Provider Demographics
NPI:1386450252
Name:NEVADA DENTAL FOUNDATION
Entity type:Organization
Organization Name:NEVADA DENTAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:WINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-326-9461
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY STE 440-368
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6170
Mailing Address - Country:US
Mailing Address - Phone:702-326-9461
Mailing Address - Fax:
Practice Address - Street 1:825 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TONOPAH
Practice Address - State:NV
Practice Address - Zip Code:89049-1599
Practice Address - Country:US
Practice Address - Phone:775-477-3033
Practice Address - Fax:775-477-3099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA DENTAL FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty