Provider Demographics
NPI:1134265507
Name:ORR, DANIEL L II (DDS, PHD, JD, MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:ORR
Suffix:II
Gender:M
Credentials:DDS, PHD, JD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 W. CHARLESTON BLVD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2287
Mailing Address - Country:US
Mailing Address - Phone:702-383-3711
Mailing Address - Fax:702-383-2653
Practice Address - Street 1:2040 W. CHARLESTON BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2287
Practice Address - Country:US
Practice Address - Phone:702-383-3711
Practice Address - Fax:702-383-2653
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-121223S0112X, 209800000X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No209800000XAllopathic & Osteopathic PhysiciansLegal Medicine
No1223D0004XDental ProvidersDentistDental Anesthesiology