Provider Demographics
NPI:1386800415
Name:DHILLON, AMANDEEP K (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:K
Last Name:DHILLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7751 W FLAMINGO RD
Mailing Address - Street 2:SUITE A100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5401
Mailing Address - Country:US
Mailing Address - Phone:702-804-6555
Mailing Address - Fax:702-804-1998
Practice Address - Street 1:7751 W FLAMINGO RD
Practice Address - Street 2:SUITE A100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-4399
Practice Address - Country:US
Practice Address - Phone:702-804-6555
Practice Address - Fax:702-804-1998
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1546972084N0400X
NVAPPLIED-NOT ISSUED2084N0400X
MN533112084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNENROLLEDMedicaid