Provider Demographics
NPI:1538353297
Name:NEVAR, DEREK THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:THOMAS
Last Name:NEVAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 426
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-731-4700
Mailing Address - Fax:
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 426
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-731-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0225751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice