Healthcare Provider Details

I. General information

NPI: 1083303911
Provider Name (Legal Business Name): MARIA THERESA JADEAR DINGSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 S MARYLAND PKWY STE 213A
LAS VEGAS NV
89109-1565
US

IV. Provider business mailing address

5015 GOLDEN ANTELOPE WAY
LAS VEGAS NV
89139-0139
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-0100
  • Fax:
Mailing address:
  • Phone: 702-340-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: