MEDICARE: DR. ARLENITA OQUENDO GOMEZ-CRODDY D. D. S.

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	7600	NV
2	1223G0001X	General Practice Dentistry	38533	CA

General Provider Information

NPI Number	:	1790871358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARLENITA OQUENDO GOMEZ-CRODDY D. D. S.

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 STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4259
Country	:	US
Telephone Number	:	702-732-2333
Fax Number	:	702-732-0881

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/16/2024

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