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General NPI Number Information
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NPI Number | 1033729199
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Entity Type | Individual
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Provider Name | CHRISTIAN DIEGO LEPURE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 11/04/2023
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Provider Practice Location Address
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Address Line | 10870 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89135-1158
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Country | US
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Telephone | 702-254-6412
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Fax |
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Provider Business Mailing Address
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Address Line | 2745 BOTTICELLI DR
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City | HENDERSON
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State | NV
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Zip | 89052-3107
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Country | US
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Telephone | 915-253-3174
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36487
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | S7-140
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License Number State | NV
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