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NPI Code Detail

MEDICARE: DANIEL SHALEV, DDS, LTD

MEDICARE: DANIEL SHALEV, DDS, LTD
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
11223D0001XPublic Health Dentistry

General Provider Information

NPI Number : 1639730385
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANIEL SHALEV, DDS, LTD
Provider Business Mailing Address
First Line : 2510 WIGWAM PKWY STE 200
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7116
Country : US
Telephone Number : 702-263-2000
Fax Number : 702-263-3036
Provider Business Practice Location Address
First Line : 2510 WIGWAM PKWY STE 200
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7116
Country : US
Telephone Number : 702-263-2000
Fax Number : 702-263-3036
Authorized Official
Title or Position : OWNER
Name : DANIEL SHALEV
Credential : DDS
Telephone Number : 702-263-2000
Provider Enumeration Date : 06/24/2019
Last Update Date : 06/24/2019

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