Provider Demographics
NPI:1467004572
Name:HINOJOSA, SERGIO POMPEYO
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:POMPEYO
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 W SAHARA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2755
Mailing Address - Country:US
Mailing Address - Phone:702-838-0707
Mailing Address - Fax:
Practice Address - Street 1:7545 W SAHARA AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2755
Practice Address - Country:US
Practice Address - Phone:702-838-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist