MEDICARE: RIZALYNE MAY ABDELNOUR 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	6944	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6944	OTHER	NV	NEVADA DENTAL BOARD

General Provider Information

NPI Number	:	1346770120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIZALYNE MAY ABDELNOUR DMD

Provider Business Mailing Address
First Line	:	10479 FOGGY GLEN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1141
Country	:	US
Telephone Number	:	702-592-7492
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 HILLWOOD DR.
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134
Country	:	US
Telephone Number	:	702-463-8600
Fax Number	:	702-735-5244

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	06/24/2019

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