Provider Demographics
NPI:1750490553
Name:DOVE, CYAANDI RHONE (DPM)
Entity Type:Individual
Prefix:DR
First Name:CYAANDI
Middle Name:RHONE
Last Name:DOVE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 BURNHAM AVE
Mailing Address - Street 2:STE 330
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5488
Mailing Address - Country:US
Mailing Address - Phone:702-538-5457
Mailing Address - Fax:702-696-9017
Practice Address - Street 1:4275 BURNHAM AVE
Practice Address - Street 2:STE 330
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5488
Practice Address - Country:US
Practice Address - Phone:702-538-5457
Practice Address - Fax:702-696-9017
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005845213E00000X
NV0602213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0602OtherNEVADA LICENSE
NV5849640001OtherDME
NYN005845OtherN.Y PODIATR. MED. LICENS
NVP00615727OtherRAILROAD MEDICARE PART B
NV103480Medicare PIN
NYU87640Medicare UPIN