# PIYEVSKY PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Mead Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801919113
- **Authorized official:** ELLEN PIYEVSKY D.D.S. (PRESIDENT)
- **Authorized official phone:** (702) 304-1234

## Contact information

- **Practice address:** 7481 W LAKE MEAD BLVD, STE. 100, LAS VEGAS, NV 89128-0285
- **Practice address phone:** (702) 304-1234
- **Practice address fax:** (702) 304-9499
- **Mailing address:** 7481 W LAKE MEAD BLVD, STE. 100, LAS VEGAS, NV 89128-0285
- **Mailing address phone:** (702) 304-1234
- **Mailing address fax:** (702) 304-9499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3344 | NV | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020