Provider Demographics
NPI:1831507482
Name:HESS, TREVOR DON (DDS)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:DON
Last Name:HESS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 SAGEFIELD WAY #1169
Mailing Address - Street 2:
Mailing Address - City:LOGANDALE
Mailing Address - State:NV
Mailing Address - Zip Code:89021-0001
Mailing Address - Country:US
Mailing Address - Phone:801-874-9185
Mailing Address - Fax:
Practice Address - Street 1:6170 N DURANGO DR STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-3923
Practice Address - Country:US
Practice Address - Phone:725-333-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7124122300000X
WADE 60475182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist