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General NPI Number Information
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NPI Number | 1003892126
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Entity Type | Individual
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Provider Name | JOAN LANDRON DMD
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Gender | Female
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 169 N NELLIS BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89110-5320
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Country | US
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Telephone | 702-384-1010
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Fax | 702-438-8424
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Provider Business Mailing Address
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Address Line | 526 S TONOPAH DR STE. 200
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City | LAS VEGAS
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State | NV
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Zip | 89106-4043
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Country | US
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Telephone | 702-291-2031
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Fax | 702-366-1483
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 047717
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5038
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License Number State | NV
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