Provider Demographics
NPI:1548607294
Name:DOCTORS BILL AND DAVIS DENTISTRY, PLLC
Entity Type:Organization
Organization Name:DOCTORS BILL AND DAVIS DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:702-477-0040
Mailing Address - Street 1:10660 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:SUITE #110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4114
Mailing Address - Country:US
Mailing Address - Phone:702-477-0040
Mailing Address - Fax:
Practice Address - Street 1:10660 SOUTHERN HIGHLANDS PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-4114
Practice Address - Country:US
Practice Address - Phone:702-477-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS6-1211223P0221X
NVS3-2331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty