Healthcare Provider Details

I. General information

NPI: 1912630351
Provider Name (Legal Business Name): VANESSA ACEVEDO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2022
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

416 CRATER CT
HENDERSON NV
89014-4009
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9019
  • Fax:
Mailing address:
  • Phone: 702-236-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7677
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: