Provider Demographics
NPI:1699153536
Name:MEADS, TERRY CHRISTOPHER JR (DMD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:CHRISTOPHER
Last Name:MEADS
Suffix:JR
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 1:4380 W CACTUS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-8926
Mailing Address - Country:US
Mailing Address - Phone:702-570-0241
Mailing Address - Fax:
Practice Address - Street 1:4380 W CACTUS AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-8926
Practice Address - Country:US
Practice Address - Phone:702-570-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332701223P0221X
NVS6-183C1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry