DR. RAFAEL GAMBOA (NPI# 1649378324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649378324 |
| Entity Type | Organization |
| Organization Name | DR. RAFAEL GAMBOA |
| Practice Address |
1601 Lakeside Dr Reno NV 89509-3408 |
| Practice Telephone | 7753228610 |
| Practice Fax Number | 7753227698 |
| Mailing Telephone | 7753228610 |
| Mailing Fax Number | 7753227698 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RAFAEL M GAMBOA (PRESIDENT) |
| Authorized Official Telephone | 7753228610 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
913 | NV | Dental Providers |
| Street Address |
1601 LAKESIDE DR |
| City | RENO |
| State | NV |
| Zip Code | 89509-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982975934 | Gregory V. Powning | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2012-01-23 |
| 1174800940 | Louis Joseph Patetta Jr. | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2011-11-08 |
| 1396025540 | Daniel Lawrence Barrett | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2011-08-19 |
| 1205120524 | John Chadwick Shepphird | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2011-06-03 |
| 1508178633 | Craig Andresen | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2010-07-06 |
| 1871805135 | Allison Yuriko Andresen | Student in an Organized Health Care Education/Training Program | 1601 Lakeside Dr, Reno, NV 89509-3464 | 2010-07-02 |
| 1194819177 | Dr. Louis Patetta Dds | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3408 | 2006-10-03 |
| 1821181363 | Dr. Greg V Powning | Dentist | 1601 Lakeside Dr, Reno, NV 89509-3408 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992283303 | Olson Professional Services, Pllc | Electrodiagnostic Medicine | 66305 S Mccarran Blvd. Ste A4, Reno, NV 89509 | 2018-07-30 |
| 1851883607 | Matthew Christopher Peterson | Behavior Technician | 604 Moana Lane, Reno, NV 89509 | 2018-06-06 |
| 1063901155 | Board of Regents, Nevada System of Higher Education | Assistant Behavior Analyst | 604 West Moana Lane, Reno, NV 89509 | 2018-05-04 |
| 1295243517 | Megan Brenner | Counselor | 527 Plumas Street, Reno, NV 89509 | 2018-01-22 |
| 1881104099 | Trish Lee Mcguire | Occupational Therapist | 540 W Plumb Lane, Suite 201, Reno, NV 89509 | 2017-10-03 |
| 1982113825 | Sasha Bond | Behavior Technician | 3500 Lakeside Ct. #101, Reno, NV 89509 | 2017-09-22 |
| 1124547930 | Sally M Higgins | Student in an Organized Health Care Education/Training Program | 740 California Ave, Reno, NV 89509 | 2017-09-12 |
| 1851819031 | Victoria Vaughn | Counselor | 4390 Interlaken Ct., Reno, NV 89509 | 2017-09-07 |
| 1407373533 | Luis Andres Garcia Lopez | Behavior Technician | 3500 Lakeside Ct., #101, Reno, NV 89509 | 2017-08-29 |
| 1184150757 | Nevada Educational and Therapy Solutions, LLC | Speech-Language Pathologist | 1101 W Moana Lane #7, Reno, NV 89509 | 2017-05-02 |
| Find all providers in zip 89509 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568674109 | John Frank Cercek Jr. | Dentist | 805 West 7th Street, #202, Reno, NV 89503-2795 | 2007-05-04 |
| 1790808004 | John Richard Kaminski | Dentist | 1155 W 4th St Ste 218, Reno, NV 89503-5149 | 2007-04-10 |
| 1700198397 | Amy Marie Kathrean French | Dentist | 805 W 7th St, Suite 202, Reno, NV 89503-2700 | 2010-07-12 |
| 1760505176 | Kenneth Lang | Dentist | 4101 Caughlin Sq, Suite 1, Reno, NV 89519 | 2007-04-09 |
| 1255459947 | Steven D. Robinson, D.d.s., Ltd | Dentist | 3575 Grant Dr, Suite 10, Reno, NV 89509-5301 | 2007-03-27 |
| 1285752550 | Steven Douglas Robinson | Dentist | 3575 Grant Dr, Suite 10, Reno, NV 89509-5301 | 2007-03-26 |
| 1104984418 | Mark Richard Morgan | Dentist | 1155 W 4th St, Suite 218, Reno, NV 89503-5145 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619302353 | Jessica Ann Silva | Dentist | 710 Coronado Center Dr, Suite 100, Henderson, NV 89052-4289 | 2013-09-12 |
| 1710259254 | James Rogers | Dentist | 3575 S Town Center Dr, Suite 110, Las Vegas, NV 89135-3045 | 2012-01-30 |
| 1760774558 | Benjamin Ellsworth | Dentist | 505 Bachelor Button St, Las Vegas, NV 89138-6077 | 2011-05-11 |
| 1043510399 | Aaron G Radmall | Dentist | 366 W Lake Mead Pkwy #100, Henderson, NV 89015 | 2010-11-02 |
| 1518285808 | Curry H. Leavitt | Dentist | 7475 W Sahara Ave, 101, Las Vegas, NV 89117-2867 | 2010-05-11 |
| 1588861348 | Eric Bernzweig | Dentist | 6835 W Charleston Blvd, Las Vegas, NV 89117 | 2007-06-27 |
| 1285855809 | Jody Scott Harrison | Dentist | 4700 Las Vegas Blvd, Nellis Afb, NV 89191-6601 | 2007-05-01 |
| 1861515819 | Michael Almaraz, D.d.s.,ltd | Dentist | 1675 Vista Ln, Carson City, NV 89703-4640 | 2007-04-06 |
| 1235269838 | Richard Alan Mecall | Dentist | 2327 Green Mountain Ct, Las Vegas, NV 89135-1536 | 2007-03-06 |
| 1497883656 | James K. Rogers, D.d.s., M.s., L.t.d. | Dentist | 3575 S. Town Center Dr., Suite 110, Las Vegas, NV 89135 | 2007-03-01 |
| Find all providers with the same taxonomy | ||||
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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.