MEDICARE: IVY DENTAL INC.

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	3468	NV

General Provider Information

NPI Number	:	1417980665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IVY DENTAL INC.

Provider Business Mailing Address
First Line	:	740 N EASTERN AVE
Second Line	:	#120
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-2850
Country	:	US
Telephone Number	:	702-678-6218
Fax Number	:	702-678-5102

Provider Business Practice Location Address
First Line	:	740 N EASTERN AVE
Second Line	:	#120
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-2850
Country	:	US
Telephone Number	:	702-678-6218
Fax Number	:	702-678-5102

Authorized Official
Title or Position	:	DOCTOR/PRESIDENT
Name	:	DR. RICHARD Y.Y. WU
Credential	:	D.D.S.
Telephone Number	:	702-678-6218

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/24/2008

Similar Medicare Providers

1639275969 — DR. JORGE Y BURGOS MD
Practice Location Address:

750 N EASTERN AVE STE 100
LAS VEGAS, NV
89101-2850

Practice Phone: 702-227-0022
Practice Fax: 702-227-0084

1942463237 — JORGE Y BURGOS MD PC
Practice Location Address:

750 N EASTERN AVE STE 100
LAS VEGAS, NV
89101-2850

Practice Phone: 702-227-0022
Practice Fax: 702-227-0084

1942626262 — CLAUDIA PIERRE
Practice Location Address:

2850 E BONANZA RD APT 1148
LAS VEGAS, NV
89101-3691

Practice Phone: 702-280-8004
Practice Fax:

1760926505 — TILLANA ANGEL EASLEY
Practice Location Address:

2850 E BONANZA RD APT 2115
LAS VEGAS, NV
89101-8212

Practice Phone: 702-234-7049
Practice Fax:

1871096438 — BRENNAN JONES
Practice Location Address:

2850 E BONANZA RD
LAS VEGAS, NV
89101-3600

Practice Phone: 702-677-4365
Practice Fax:

1104315761 — EXTENDED LIFE LLC
Practice Location Address:

2850 CEDAR AVE APT 171
LAS VEGAS, NV
89101-3871

Practice Phone: 702-351-8288
Practice Fax:

Directions to “IVY DENTAL INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.