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General NPI Number Information
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NPI Number | 1619847837
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Entity Type | Organization
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Legal Business Name | WEST VALLEY DENTAL LLC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 9827 W TROPICANA AVE STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89147-8489
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Country | US
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Telephone | 702-255-9154
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Fax |
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Provider Business Mailing Address
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Address Line | 220 E HORIZON DR STE F
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City | HENDERSON
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State | NV
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Zip | 89015-8001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ALEX SONG
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Credential | DDS
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Telephone | 702-565-0000
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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 |
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License Number State |
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