Provider Demographics
NPI:1093262404
Name:ESPINUEVA, RONALD (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:ESPINUEVA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 LA SERNA ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-2847
Mailing Address - Country:US
Mailing Address - Phone:702-260-4450
Mailing Address - Fax:
Practice Address - Street 1:5320 W SAHARA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0375
Practice Address - Country:US
Practice Address - Phone:702-871-4990
Practice Address - Fax:702-871-9853
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV66901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV6690OtherNEVADA BOARD OF DENTAL EXAMINERS