Provider Demographics
NPI:1275625154
Name:WHETTEN, JOSHUA LOREN (DDS, MSC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:LOREN
Last Name:WHETTEN
Suffix:
Gender:M
Credentials:DDS, MSC
Other - Prefix:
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Mailing Address - Street 1:7445 W. AZURE DR.
Mailing Address - Street 2:STE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130
Mailing Address - Country:US
Mailing Address - Phone:702-360-3759
Mailing Address - Fax:702-437-3759
Practice Address - Street 1:7445 W. AZURE DR.
Practice Address - Street 2:STE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130
Practice Address - Country:US
Practice Address - Phone:702-360-3759
Practice Address - Fax:702-437-3759
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT5030821122300000X
NV40811223X0400X
NVS3771223X0400X
NVS3-771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist