Provider Demographics
NPI:1205458262
Name:CROSSWHITE, JANET E (RDH)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:E
Last Name:CROSSWHITE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6337 HAWTHORN WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1389
Mailing Address - Country:US
Mailing Address - Phone:702-272-0744
Mailing Address - Fax:702-272-0744
Practice Address - Street 1:6337 HAWTHORN WOODS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1389
Practice Address - Country:US
Practice Address - Phone:702-272-0744
Practice Address - Fax:702-272-0744
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101593124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist