Provider Demographics
NPI:1124186515
Name:EDINGTON, MARK DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:EDINGTON
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 1:9895 S MARYLAND PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7165
Mailing Address - Country:US
Mailing Address - Phone:702-372-4039
Mailing Address - Fax:
Practice Address - Street 1:9895 S MARYLAND PKWY STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7165
Practice Address - Country:US
Practice Address - Phone:702-372-4039
Practice Address - Fax:702-270-0598
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV43621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice