MEDICARE: JOEL B DASHUT DDS

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
1	1223G0001X	General Practice Dentistry	3327	NV

General Provider Information

NPI Number	:	1407872245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL B DASHUT DDS

Provider Business Mailing Address
First Line	:	941 GRANGER FARM WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8619
Country	:	US
Telephone Number	:	702-696-0866
Fax Number	:

Provider Business Practice Location Address
First Line	:	4358 W CHEYENNE AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-2484
Country	:	US
Telephone Number	:	702-735-9500
Fax Number	:	702-693-6500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/08/2007

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