Healthcare Provider Details

I. General information

NPI: 1083328454
Provider Name (Legal Business Name): CHRISTY LEIGH DAVIS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY LEIGH THOMAS RDH, B.S., CDA

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 09/28/2026
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 VALLEYWOOD ST
HENDERSON NV
89014
US

IV. Provider business mailing address

2741 TURTLEBAY AVE
HENDERSON NV
89074-1256
US

V. Phone/Fax

Practice location:
  • Phone: 314-413-1568
  • Fax:
Mailing address:
  • Phone: 314-413-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number101927
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: