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NPI Code Detail

MEDICARE: JAMES NNAH DMD

MEDICARE: JAMES NNAH DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry7402NV

General Provider Information

NPI Number : 1083218895
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES NNAH DMD
Provider Business Mailing Address
First Line : 7084 ARABIAN RIDGE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-3419
Country : US
Telephone Number : 781-801-6216
Fax Number :
Provider Business Practice Location Address
First Line : 6180 N DECATUR BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1505
Country : US
Telephone Number : 702-359-3107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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