Provider Demographics
NPI:1093802464
Name:CRESSMAN, TODD H (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:H
Last Name:CRESSMAN
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 1:5527 S RAINBOW BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1882
Mailing Address - Country:US
Mailing Address - Phone:702-367-4440
Mailing Address - Fax:702-365-0723
Practice Address - Street 1:5527 S RAINBOW BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1882
Practice Address - Country:US
Practice Address - Phone:702-367-4440
Practice Address - Fax:702-365-0723
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV35161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2202727Medicaid