Provider Demographics
NPI:1275615882
Name:KERIO, AMMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMMAR
Middle Name:
Last Name:KERIO
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 1:1580 E DESERT INN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2548
Mailing Address - Country:US
Mailing Address - Phone:702-655-6777
Mailing Address - Fax:702-547-3522
Practice Address - Street 1:1580 E DESERT INN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2548
Practice Address - Country:US
Practice Address - Phone:702-655-6777
Practice Address - Fax:702-547-3522
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4647T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4647TOtherDENTAL LINCENSE