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NPI Code Detail

MEDICARE: DR. FLORIDA TRAIVAI D.M.D.

MEDICARE: DR. FLORIDA TRAIVAI D.M.D.
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
11223G0001XGeneral Practice Dentistry5120NV

General Provider Information

NPI Number : 1093811259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FLORIDA TRAIVAI D.M.D.
Provider Business Mailing Address
First Line : 7975 W SAHARA AVE
Second Line : SUITE 102
City : LAS VEGAS
State : NV
Zip : 89117-7942
Country : US
Telephone Number : 702-545-0722
Fax Number : 702-545-0787
Provider Business Practice Location Address
First Line : 7975 W SAHARA AVE
Second Line : SUITE 102
City : LAS VEGAS
State : NV
Zip : 89117-7942
Country : US
Telephone Number : 702-545-0722
Fax Number : 702-545-0787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 03/15/2015

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