Provider Demographics
NPI:1265558878
Name:UTLEY, JARED DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:DAVID
Last Name:UTLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 E SUNSET RD STE 301
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-6206
Mailing Address - Country:US
Mailing Address - Phone:702-435-3901
Mailing Address - Fax:702-435-1378
Practice Address - Street 1:3431 E SUNSET RD STE 301
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-6206
Practice Address - Country:US
Practice Address - Phone:702-435-3901
Practice Address - Fax:702-435-1378
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist