Provider Demographics
NPI:1619325941
Name:BRITTING, MICHAEL E (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:BRITTING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2250 S RANCHO DR
Mailing Address - Street 2:STE. 205
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4451
Mailing Address - Country:US
Mailing Address - Phone:702-291-2031
Mailing Address - Fax:702-984-7566
Practice Address - Street 1:956 TOPSY LN STE 103
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-8447
Practice Address - Country:US
Practice Address - Phone:775-391-8797
Practice Address - Fax:775-267-4288
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV67631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1619325941Medicaid