Healthcare Provider Details

I. General information

NPI: 1093721060
Provider Name (Legal Business Name): ZACHARY B TRUMAN DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZACHARY B TRUMAN DMD MSD

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10855 S EASTERN AVE
HENDERSON NV
89052-5704
US

IV. Provider business mailing address

880 SEVEN HILLS DR SUITE 170
HENDERSON NV
89052
US

V. Phone/Fax

Practice location:
  • Phone: 702-221-2272
  • Fax: 702-222-3277
Mailing address:
  • Phone: 702-221-2272
  • Fax: 702-222-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS364
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-64
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: