Provider Demographics
NPI:1790715951
Name:YELTON, DERREK ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DERREK
Middle Name:ARTHUR
Last Name:YELTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 W. FLAMINGO RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2312
Mailing Address - Country:US
Mailing Address - Phone:702-365-1743
Mailing Address - Fax:702-365-1167
Practice Address - Street 1:5660 W. FLAMINGO RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2312
Practice Address - Country:US
Practice Address - Phone:702-365-1743
Practice Address - Fax:702-365-1167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist