Healthcare Provider Details

I. General information

NPI: 1447779640
Provider Name (Legal Business Name): DAVID CHENIN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4306 S EASTERN AVE
LAS VEGAS NV
89119-6016
US

IV. Provider business mailing address

8965 S EASTERN AVE STE 360
LAS VEGAS NV
89123-4893
US

V. Phone/Fax

Practice location:
  • Phone: 702-735-4169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID ALAN CHENIN
Title or Position: MANAGER
Credential: DDS., MSD
Phone: 702-524-6041