Healthcare Provider Details
I. General information
NPI: 1992772537
Provider Name (Legal Business Name): JOSHUA LEWIS SAXE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 03/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8710 W CHARLESTON BLVD SUITE 100
LAS VEGAS NV
89117-5469
US
IV. Provider business mailing address
8710 W CHARLESTON BLVD SUITE 100
LAS VEGAS NV
89117-5469
US
V. Phone/Fax
- Phone: 702-255-0133
- Fax: 702-255-8374
- Phone: 702-255-0133
- Fax: 702-255-8374
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | S6-25 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: