Provider Demographics
NPI:1336204304
Name:CALVO, ERVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERVIN
Middle Name:
Last Name:CALVO
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 1:11763 LONGWORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1322
Mailing Address - Country:US
Mailing Address - Phone:310-625-1695
Mailing Address - Fax:
Practice Address - Street 1:560 N NELLIS BLVD
Practice Address - Street 2:SUITE E8
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5369
Practice Address - Country:US
Practice Address - Phone:702-459-0303
Practice Address - Fax:702-459-2111
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV50941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice