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NPI Code Detail

MEDICARE: DR. DARLENE TEDDY DDS

MEDICARE: DR. DARLENE TEDDY DDS
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
1122300000XDentist7144NV

General Provider Information

NPI Number : 1346716057
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARLENE TEDDY DDS
Provider Business Mailing Address
First Line : 2381 E WINDMILL LN STE 11
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2069
Country : US
Telephone Number : 702-522-2888
Fax Number : 702-522-2889
Provider Business Practice Location Address
First Line : 2381 E WINDMILL LN STE 11
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2069
Country : US
Telephone Number : 702-522-2888
Fax Number : 702-522-2889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2018
Last Update Date : 03/04/2026

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