MEDICARE: DR. DANIEL I SHALEV D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	3743	NV

General Provider Information

NPI Number	:	1013928761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL I SHALEV D.D.S.

Provider Business Mailing Address
First Line	:	2510 WIGWAM PKWY STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-263-2000
Fax Number	:	702-263-3036

Provider Business Practice Location Address
First Line	:	2510 WIGWAM PKWY STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7116
Country	:	US
Telephone Number	:	702-263-2000
Fax Number	:	702-263-3036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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