SUMMIT BOULEVARD DENTAL (NPI# 1063900595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063900595 |
Entity Type | Organization |
Organization Name | SUMMIT BOULEVARD DENTAL |
Practice Address |
13985 S Virginia St Ste 806 Reno NV 89511-8934 |
Practice Telephone | 7758464777 |
Practice Fax Number | 7755255512 |
Mailing Telephone | 7758464777 |
Mailing Fax Number | 7755255512 |
Enumeration Date | 2018-04-30 |
Last Update Date | 2018-04-30 |
Authorized Official Name | DR. TIMOTHY ADAMS (OWNER) |
Authorized Official Telephone | 6156014728 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223E0200X |
Dentist Specialization: Endodontics |
S7-881 | NV | Dental Providers |
Y | 122300000X | Dentist | S7-88C | NV | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DENTISTRY | 1306026679 | 01 |
Street Address |
13985 S VIRGINIA ST STE 806 |
City | RENO |
State | NV |
Zip Code | 89511-8934 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407474695 | Katherine Lynn Mauldin | Physician Assistant | Redfield Campus Nell J. Redfield Bldg. A Suite 104, 18600 Wedge Parkway, Reno, NV 89511 | 2020-07-14 |
1902428915 | Roxann Jeanette Richardson | Student in an Organized Health Care Education/Training Program | Unr Redfield Campus Nell J. Redfield Bldg. A, Suite 104 18600 Wedge Parkway, Reno, NV 89511 | 2020-05-13 |
1487286654 | Noelle Marie Davis-marinaccio | Nurse Practitioner | 5570 Longley Lane, Reno, NV 89511 | 2020-02-06 |
1265092662 | Elysia Jones | Student in an Organized Health Care Education/Training Program | 18600 Wedge Parkway, Nell J. Redfield Building A, Suite 104, Reno, NV 89511 | 2019-06-18 |
1023583622 | Vera Whole Health, Wa PC | Clinic/Center | 699 Sierra Rose Drive, Reno, NV 89511 | 2018-10-10 |
1841786027 | Christina Willett | Speech-Language Pathologist | 14680 S. Quiet Meadow Drive, Reno, NV 89511 | 2018-07-10 |
1235630864 | High Sierra Psychiatry, LLC | Clinic/Center | Reno Behavioral Healthcare Hospital, 6940 Sierra Center Parkway, Reno, NV 89511 | 2018-02-28 |
1154839637 | Jacob Blake, Md Ltd. | Anesthesiology | 5590 Kietzke Lane, Reno, NV 89511 | 2018-01-18 |
1548776024 | Jennifer L. Shane O.d., Ltd | Optometrist | 5385 Reno Corporate Drive #100, Reno, NV 89511 | 2017-12-20 |
1619488525 | Reno Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 6940 Sierra Center Parkway, Reno, NV 89511 | 2017-10-18 |
Find all providers in zip 89511 |
Taxonomy Code | 122300000X |
Grouping | Dental Providers |
Classification | Dentist |
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861091167 | Clare Haeram Lee | Dentist | 570 Putnam Dr, Reno, NV 89503-1636 | 2020-10-19 |
1144827767 | Smilerestore | Dentist | 5365 Mae Anne Ave Ste B1, Reno, NV 89523-1897 | 2020-10-06 |
1174006373 | Cressman Dental Group, PC | Dentist | 6360 Mae Anne Ave Ste 3, Reno, NV 89523-4719 | 2018-09-13 |
1760964027 | Whitney Irene Bryant | Dentist | 35 Regency Way Ste C, Reno, NV 89509-3446 | 2018-09-04 |
1225515356 | Shirin Abboud | Dentist | 5150 Mae Anne Ave Ste 810a, Reno, NV 89523-1881 | 2018-07-21 |
1821519877 | Heather Nicole Olson | Dentist | 6395 S Mccarran Blvd # B, Reno, NV 89509-6101 | 2017-06-29 |
1659801819 | Nathan Antoine | Dentist | 280 Vista Knoll Pkwy Ste 114, Reno, NV 89506-5649 | 2017-06-19 |
1891238614 | Dentistry for Kids, LLC | Dentist | 10455 Double R Blvd Ste 100, Reno, NV 89521-8905 | 2016-11-28 |
1528512571 | Dustin K Harrington | Dentist | 280 Vista Knoll Pkwy, 114, Reno, NV 89506-5647 | 2016-08-08 |
1598113607 | Salar and Del Isle LLC | Dentist | 5059 S. Mccarran Blvd, Reno, NV 89502-6530 | 2016-05-31 |
Find all providers in RENO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.