Provider Demographics
NPI:1639861776
Name:CRUZ, ALAN JOSEPH LEGASPI (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN JOSEPH
Middle Name:LEGASPI
Last Name:CRUZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 JACK RABBIT WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-2635
Mailing Address - Country:US
Mailing Address - Phone:702-427-6205
Mailing Address - Fax:
Practice Address - Street 1:6525 N DECATUR BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-2993
Practice Address - Country:US
Practice Address - Phone:702-577-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist