Provider Demographics
NPI:1235250796
Name:DOS SANTOS, LUIZ ALFREDO (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIZ
Middle Name:ALFREDO
Last Name:DOS SANTOS
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 1:1350 S JONES BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1233
Mailing Address - Country:US
Mailing Address - Phone:702-870-6161
Mailing Address - Fax:702-870-2302
Practice Address - Street 1:1350 S JONES BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1206
Practice Address - Country:US
Practice Address - Phone:702-870-6161
Practice Address - Fax:702-648-7343
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV50581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice