Provider Demographics
NPI:1023251170
Name:GATAN, ADAM JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:GATAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 S. EASTERN AVE
Mailing Address - Street 2:#248
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123
Mailing Address - Country:US
Mailing Address - Phone:702-384-0053
Mailing Address - Fax:702-269-6063
Practice Address - Street 1:9550 S. EASTERN AVE
Practice Address - Street 2:#248
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-384-0053
Practice Address - Fax:702-269-6063
Is Sole Proprietor?:No
Enumeration Date:2009-04-18
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS7-681223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223E0200XDental ProvidersDentistEndodontics