Individual
DUSTIN LANSING BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA3394
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669039525
DOD
—
Enumeration date
05/24/2019
Last updated
04/09/2026
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