=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831398841
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARDINALE MANAGEMENT PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2007
-----------------------------------------------------
Last Update Date | 07/17/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3774 E DESERT INN RD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89121-3339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-257-2872
-----------------------------------------------------
Fax | 702-257-2880
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3774 E DESERT INN RD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89121-3339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-257-2872
-----------------------------------------------------
Fax | 702-257-2880
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | FRANCESCA SOPHIA CARDINALE
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 702-257-2872
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 4053
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------