Provider Demographics
NPI:1689725467
Name:HALE AND DOWNEY FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:HALE AND DOWNEY FAMILY DENTISTRY, P.C.
Other - Org Name:HALE AND DOWNEY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-871-4903
Mailing Address - Street 1:5660 W FLAMINGO RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-0171
Mailing Address - Country:US
Mailing Address - Phone:702-871-4903
Mailing Address - Fax:702-871-1485
Practice Address - Street 1:5660 W FLAMINGO RD
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-0171
Practice Address - Country:US
Practice Address - Phone:702-871-4903
Practice Address - Fax:702-871-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV34661223G0001X
NV08831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty