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General NPI Number Information
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NPI Number | 1023749157
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Entity Type | Individual
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Provider Name | KEVIN JAY ANDREWS D.D.S.,M.S.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 2125 GREEN VISTA DR STE 104
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City | SPARKS
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State | NV
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Zip | 89431-8515
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Country | US
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Telephone | 775-527-7953
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Fax | 775-674-1515
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Provider Business Mailing Address
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Address Line | 2125 GREEN VISTA DR STE 104
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City | SPARKS
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State | NV
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Zip | 89431-8515
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Country | US
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Telephone | 775-527-7953
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Fax | 775-674-1515
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 345
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License Number State | NV
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