Provider Demographics
NPI:1922412030
Name:CROWLEY, CHASE ELLIOTT (DDS, MS)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:ELLIOTT
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10487 BECKAVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-3226
Mailing Address - Country:US
Mailing Address - Phone:702-461-9830
Mailing Address - Fax:
Practice Address - Street 1:4450 N TENAYA WAY STE 240
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7140
Practice Address - Country:US
Practice Address - Phone:702-463-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-024176122300000X
NVS7-941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist