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General NPI Number Information
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NPI Number | 1902194079
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Entity Type | Individual
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Provider Name | KEVIN DEAN BALDWIN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 8670 W CHEYENNE AVE STE 205
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City | LAS VEGAS
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State | NV
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Zip | 89129-7457
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Country | US
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Telephone | 702-360-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 10420 NOSTALGIA CIR
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City | LAS VEGAS
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State | NV
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Zip | 89135-1023
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Country | US
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Telephone | 614-599-9677
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D9586
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License Number State | OR
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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 | 6402
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License Number State | NV
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