SUMMIT BOULEVARD DENTAL


Address: 13985 S Virginia St Ste 806, Reno, NV 89511-8934
Phone: 7758464777

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
DENTISTRY 1306026679 01

Office Location

Street Address 13985 S VIRGINIA ST STE 806
City RENO
State NV
Zip Code 89511-8934

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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

Providers in the same taxonomy and city

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
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Competitor

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City RENO
Zip Code 89511

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Dataset Information

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.

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