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Contact Information

SUMMIT BOULEVARD DENTAL
13985 S VIRGINIA ST STE 806
RENO, NV89511-8934
 Phone: 775-846-4777
 Fax: 775-525-5512
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for SUMMIT BOULEVARD DENTAL

NPI # 1063900595
LBN Legal business name SUMMIT BOULEVARD DENTAL
Authorized official TIMOTHY ADAMS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/30/2018
Last updated 04/30/2018 - About 8 years ago
Identifiers
NV License # S7-881
NV License # S7-88C
Other 1306026679 DENTISTRY
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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