Provider Demographics
NPI:1831487701
Name:DENTON, JAY THOMAS (DDS)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:THOMAS
Last Name:DENTON
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 1:7425 W AZURE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4425
Mailing Address - Country:US
Mailing Address - Phone:702-878-4397
Mailing Address - Fax:702-425-9948
Practice Address - Street 1:7425 W AZURE DR STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4425
Practice Address - Country:US
Practice Address - Phone:702-878-4397
Practice Address - Fax:702-425-9948
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV62851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice