Provider Demographics
NPI:1033729199
Name:LEPURE, CHRISTIAN DIEGO (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:DIEGO
Last Name:LEPURE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 BOTTICELLI DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3107
Mailing Address - Country:US
Mailing Address - Phone:915-253-3174
Mailing Address - Fax:
Practice Address - Street 1:10870 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1158
Practice Address - Country:US
Practice Address - Phone:702-254-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364871223G0001X
NVS7-1401223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice