Healthcare Provider Details

I. General information

NPI: 1750417887
Provider Name (Legal Business Name): KATHLEEN FELICE OLENDER BS,DDS,MS,FICOI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 W SAHARA AVE
LAS VEGAS NV
89117-2742
US

IV. Provider business mailing address

7520 W SAHARA AVE
LAS VEGAS NV
89117-2742
US

V. Phone/Fax

Practice location:
  • Phone: 702-384-7200
  • Fax: 702-384-7593
Mailing address:
  • Phone: 702-384-7200
  • Fax: 702-384-7593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberS723
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: