Provider Demographics
NPI:1609457845
Name:GHERIANI, YASSER
Entity Type:Individual
Prefix:
First Name:YASSER
Middle Name:
Last Name:GHERIANI
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 1:5475 S FORT APACHE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6410
Mailing Address - Country:US
Mailing Address - Phone:702-702-1609
Mailing Address - Fax:725-525-7641
Practice Address - Street 1:5475 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6410
Practice Address - Country:US
Practice Address - Phone:702-702-1609
Practice Address - Fax:725-525-7641
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist