Provider Demographics
NPI:1851404669
Name:OCCHIALINO, RICHARD D (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:OCCHIALINO
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 1:1485 W WARM SPRINGS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-616-1942
Mailing Address - Fax:702-898-7580
Practice Address - Street 1:1485 W WARM SPRINGS RD
Practice Address - Street 2:STE 101
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-616-1942
Practice Address - Fax:702-898-7580
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV36901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice