Provider Demographics
NPI:1790111672
Name:GUIRGUIS, NADIM MORAD (DMD)
Entity Type:Individual
Prefix:DR
First Name:NADIM
Middle Name:MORAD
Last Name:GUIRGUIS
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 1:7588 PEARL CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3291
Mailing Address - Country:US
Mailing Address - Phone:702-285-2263
Mailing Address - Fax:
Practice Address - Street 1:7125 N DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4466
Practice Address - Country:US
Practice Address - Phone:702-658-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610431223X0400X
NVS3-267C1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics