Provider Demographics
NPI:1255733549
Name:DAVID TING DMD,APC
Entity type:Organization
Organization Name:DAVID TING DMD,APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:LEABREA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-522-2275
Mailing Address - Street 1:6960 WESTCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1270 CONCANNON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6002
Practice Address - Country:US
Practice Address - Phone:702-522-2275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty