Provider Demographics
NPI:1154628253
Name:WEST, PAMELA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:WEST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 VILLAGE CENTER CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6253
Mailing Address - Country:US
Mailing Address - Phone:702-240-0400
Mailing Address - Fax:702-242-0004
Practice Address - Street 1:2095 VILLAGE CENTER CIR STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6253
Practice Address - Country:US
Practice Address - Phone:702-240-0400
Practice Address - Fax:702-242-0004
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV28951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice