Provider Demographics
NPI:1881674935
Name:CONVEY, LADAN A (DDS)
Entity type:Individual
Prefix:DR
First Name:LADAN
Middle Name:A
Last Name:CONVEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 TIERRA NORA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4307
Mailing Address - Country:US
Mailing Address - Phone:931-494-4667
Mailing Address - Fax:
Practice Address - Street 1:3133 TIERRA NORA
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4307
Practice Address - Country:US
Practice Address - Phone:931-494-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7351122300000X
TX41107122300000X
VA0401410289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist