MEDICARE: DR. DAVID ARMEL GOMEZ CRODDY 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
1	122300000X	Dentist	104117	CA
2	122300000X	Dentist	7331	NV

General Provider Information

NPI Number	:	1407409089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ARMEL GOMEZ CRODDY DDS

Provider Business Mailing Address
First Line	:	3700 PECOS MCLEOD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4259
Country	:	US
Telephone Number	:	702-732-2333
Fax Number	:	702-732-0881

Provider Business Practice Location Address
First Line	:	3700 PECOS MCLEOD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4257
Country	:	US
Telephone Number	:	916-606-4522
Fax Number	:

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

Provider Enumeration Date	:	07/22/2019
Last Update Date	:	02/12/2024

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