Provider Demographics
NPI:1558397885
Name:LOVELAND, DARREN T (DMD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:T
Last Name:LOVELAND
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 1:7345 S DURANGO DR STE 112
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3608
Mailing Address - Country:US
Mailing Address - Phone:702-270-3095
Mailing Address - Fax:702-739-3058
Practice Address - Street 1:7345 S DURANGO DR STE 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3608
Practice Address - Country:US
Practice Address - Phone:702-270-3095
Practice Address - Fax:702-739-3058
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV37261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice