Provider Demographics
NPI:1407213564
Name:WEST LOVERS DENTAL PLLC
Entity Type:Organization
Organization Name:WEST LOVERS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-997-7707
Mailing Address - Street 1:5757 W LOVERS LN
Mailing Address - Street 2:109
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-5166
Mailing Address - Country:US
Mailing Address - Phone:702-997-7707
Mailing Address - Fax:
Practice Address - Street 1:7545 W SAHARA AVE
Practice Address - Street 2:210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2866
Practice Address - Country:US
Practice Address - Phone:702-838-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty