Provider Demographics
NPI:1245951144
Name:DAVID, ROXANNE DENISE (DMD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE DENISE
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ROXANNE DENISE
Other - Middle Name:PANALIGAN
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2810 W HORIZON RIDGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4593
Mailing Address - Country:US
Mailing Address - Phone:702-686-8462
Mailing Address - Fax:
Practice Address - Street 1:2810 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4593
Practice Address - Country:US
Practice Address - Phone:702-848-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV75701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice