Provider Demographics
NPI:1447326186
Name:MAVROIDIS, DEBRA F (DDS)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:F
Last Name:MAVROIDIS
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 1:124 S ROYAL ASCOT DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4309
Mailing Address - Country:US
Mailing Address - Phone:702-596-6306
Mailing Address - Fax:702-651-7383
Practice Address - Street 1:6375 W CHARLESTON BLVD STE A500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-651-5510
Practice Address - Fax:702-651-7383
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2018-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL001702122300000X
NV7037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist