MEDICARE: DR. WILLIAM R HYMAN DDS MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	33781	CA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-373C	NV

General Provider Information

NPI Number	:	1700076601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM R HYMAN DDS MS

Provider Business Mailing Address
First Line	:	15 BOULDERBACK DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-7286
Country	:	US
Telephone Number	:	323-401-1252
Fax Number	:

Provider Business Practice Location Address
First Line	:	3896 N MARTIN LUTHER KING BLVD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032
Country	:	US
Telephone Number	:	702-614-1792
Fax Number	:

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	06/20/2023

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