SHAHRESTANI SPARKS MARINA DENTISTRY, PC (NPI# 1760861447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760861447 |
| Entity Type | Organization |
| Organization Name | SHAHRESTANI SPARKS MARINA DENTISTRY, PC |
| Other Organization Name | SPARKS MARINA DENTISTRY |
| Practice Address |
475 Sparks Blvd Suite 101 Sparks NV 89434-9002 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 7753591565 |
| Practice Fax Number | 7753591597 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |
| Authorized Official Name | ALI SHAHRESTANI (CREDENTIALING ADMINISTRATOR) |
| Authorized Official Telephone | 7148458704 |
| Authorized Official Credential | CYNTHIA CASTILLO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Sparks Marina Dentistry | Doing Business As Name - Organization |
| Street Address |
475 SPARKS BLVD SUITE 101 |
| City | SPARKS |
| State | NV |
| Zip Code | 89434-9002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750546578 | Rebecca Erine Rores | Dentist | 475 Sparks Blvd, Sparks, NV 89434-9002 | 2008-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750992210 | Erin Heffelfinger | Rehabilitation Practitioner | 550 Marina Gateway Dr, Apt 1432, Sparks, NV 89434 | 2020-08-10 |
| 1568009892 | Daniel Wesley Jacobson | Home Health Aide | 800 Nichols Bldv #222, Sparks, NV 89434 | 2019-12-05 |
| 1437649688 | Barbara M Robinson | Home Health Aide | 1963 E. Prayer Way, Sparks, NV 89434 | 2018-05-14 |
| 1851788277 | P6 Family Services LLC | Case Management | 2200 North D'andrea Pkwy #2411, Sparks, NV 89434 | 2015-04-23 |
| 1700188430 | Etxea Services | Community/Behavioral Health | 741 Rancho Villa Drive, Sparks, NV 89434 | 2010-12-01 |
| 1194970640 | Steven Joel Madison | Registered Nurse | 1999 Mania Court, Sparks, NV 89434 | 2008-11-25 |
| 1730342155 | Raymond Miranda Duro | Pharmacist | 2375 East Prater Way Sparks, Sparks, NV 89434 | 2008-07-07 |
| 1124293436 | Steve D Smith | Hearing Instrument Specialist | 1450 E Prater Way Ste 111, Sparks, NV 89434 | 2008-04-28 |
| 1437355799 | Kristin Leigh Koetje | Social Worker | 310 Rue De La Lavanda, Sparks, NV 89434 | 2007-06-25 |
| 1063549582 | Urology Institute | Urology | 2385 E Prater Way Suite 112, Sparks, NV 89434 | 2007-02-28 |
| Find all providers in zip 89434 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386191005 | James Kang | Dentist | 475 Sparks Blvd Ste 101, Sparks, NV 89434-9002 | 2016-09-11 |
| 1518355395 | Kid Dental LLC | Dentist | 1301 N Mccarran Blvd Ste 104, Sparks, NV 89431-3870 | 2015-01-02 |
| 1508208547 | Ah Reum Park | Dentist | 5015 Pyramid Way, #113, Sparks, NV 89436-7746 | 2013-07-18 |
| 1700059748 | Absolute Dental Sp LLC | Dentist | 5015 Pyramid Lakes Rd., Sparks, NV 89436-7746 | 2008-04-10 |
| 1083892863 | Marty Wayne Martin | Dentist | 5015 Pyramid Way Unit 113, Sparks, NV 89436-7728 | 2008-02-04 |
| 1801084678 | Charles Cordova Jr. | Dentist | 2399 Wingfield Hills Rd Ste 130, Sparks, NV 89436-7208 | 2007-10-05 |
| 1235329780 | Andrew Ryan Champagne | Dentist | 735 Sparks Blvd, Sparks, NV 89434-7930 | 2007-07-31 |
| 1073724951 | Bryan H. Peters | Dentist | 840 I St Ste 3, Sparks, NV 89431-3697 | 2007-05-24 |
| 1023222379 | Frank D Caffaratti | Dentist | 3160 N Truckee Ln, Sparks, NV 89434-1583 | 2007-05-09 |
| 1912125162 | Spanish Springs Family Dental | Dentist | 5050 Vista Blvd, Suite 107, Sparks, NV 89436-2844 | 2007-04-23 |
| Find all providers in SPARKS | ||||
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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.