MEDICARE: CORONA DENTAL & DENTURES, XA PROF. CORP.

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	3780	NV

General Provider Information

NPI Number	:	1548592710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORONA DENTAL & DENTURES, XA PROF. CORP.

Provider Business Mailing Address
First Line	:	5080 E BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3524
Country	:	US
Telephone Number	:	702-456-5100
Fax Number	:	702-456-5102

Provider Business Practice Location Address
First Line	:	5080 E BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3524
Country	:	US
Telephone Number	:	702-456-5100
Fax Number	:	702-456-5102

Authorized Official
Title or Position	:	DENTIST
Name	:	HAI XA
Credential	:	DMD
Telephone Number	:	702-456-5100

Provider Enumeration Date	:	02/12/2010
Last Update Date	:	02/12/2010

Similar Medicare Providers

1114249356 — VIHAR PATEL
Practice Location Address:

5050 E BONANZA RD
LAS VEGAS, NV
89110-3524

Practice Phone: 702-459-1003
Practice Fax:

1558336792 — MRS. NORMA FAITH SORELLE C.R.N.A.
Practice Location Address:

3524 MORENO CT
LAS VEGAS, NV
89129-6312

Practice Phone: 775-375-5745
Practice Fax: 702-998-6977

1639498702 — NEVADA ANESTHESIA PROFESSIONALS LLC
Practice Location Address:

3524 MORENO CT
LAS VEGAS, NV
89129-6312

Practice Phone: 508-971-6194
Practice Fax: 702-998-6977

1255679320 — DR. VICTOR KEITH KNUTZEN MD, FACS, FACOG.
Practice Location Address:

313 PILOT RD STE B
LAS VEGAS, NV
89119-3524

Practice Phone: 725-204-8972
Practice Fax: 725-204-9612

1548712292 — GERALD KERR
Practice Location Address:

3524 MILFORD HAVEN ST
LAS VEGAS, NV
89122-3637

Practice Phone: 716-444-1089
Practice Fax:

1518785088 — VICTOR KNUTZEN, MD
Practice Location Address:

313 PILOT RD STE B
LAS VEGAS, NV
89119-3524

Practice Phone: 725-204-8972
Practice Fax: 725-204-9612

Directions to “CORONA DENTAL & DENTURES, XA PROF. CORP. ” 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.