Provider Demographics
NPI:1699415349
Name:AVENDANO, DENNEZ (DMD)
Entity Type:Individual
Prefix:
First Name:DENNEZ
Middle Name:
Last Name:AVENDANO
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 1:1700 ALTA DR APT 1102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4168
Mailing Address - Country:US
Mailing Address - Phone:949-867-8053
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 123C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2323
Practice Address - Country:US
Practice Address - Phone:509-474-7496
Practice Address - Fax:509-474-7499
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program