MEDICARE: JOSEPH WEINTRAUB 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	34532	TX

General Provider Information

NPI Number	:	1750860300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH WEINTRAUB DMD

Provider Business Mailing Address
First Line	:	9542 VAST VALLEY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4237
Country	:	US
Telephone Number	:	702-785-2927
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 HEIGHTS DR STE 2
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-2185
Country	:	US
Telephone Number	:	702-870-2927
Fax Number	:

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

Provider Enumeration Date	:	08/13/2018
Last Update Date	:	08/13/2018

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