Provider Demographics
NPI:1174824148
Name:GUIDENG, ROMULO JOSEPH JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROMULO
Middle Name:JOSEPH
Last Name:GUIDENG
Suffix:JR
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 1:7731 VICTORY GALLUP ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4123
Mailing Address - Country:US
Mailing Address - Phone:702-461-7404
Mailing Address - Fax:
Practice Address - Street 1:6525 N DECATUR BLVD
Practice Address - Street 2:STE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-2992
Practice Address - Country:US
Practice Address - Phone:702-577-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV60631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice