Provider Demographics
NPI:1790871358
Name:GOMEZ-CRODDY, ARLENITA OQUENDO (D D S)
Entity Type:Individual
Prefix:DR
First Name:ARLENITA
Middle Name:OQUENDO
Last Name:GOMEZ-CRODDY
Suffix:
Gender:F
Credentials:D D S
Other - Prefix:DR
Other - First Name:MARIA ARLENITA
Other - Middle Name:OQUENDO
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:D D S
Mailing Address - Street 1:3700 PECOS MCLEOD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4259
Mailing Address - Country:US
Mailing Address - Phone:702-732-2333
Mailing Address - Fax:702-732-0881
Practice Address - Street 1:3700 PECOS MCLEOD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4259
Practice Address - Country:US
Practice Address - Phone:702-732-2333
Practice Address - Fax:702-732-0881
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7600122300000X
CA385331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice