MEDICARE: DR. JAMES KENT WEBER DMD

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	1223G0001X	General Practice Dentistry	4653	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114064219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES KENT WEBER DMD

Provider Business Mailing Address
First Line	:	2850 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3605
Country	:	US
Telephone Number	:	702-454-0858
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3605
Country	:	US
Telephone Number	:	702-454-0858
Fax Number	:

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/04/2009

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