Melissa Amaral

Individual provider Active NPI General Practice Dentistry · Reno, NV

NPI 1831254622 · NPPES record last updated Apr 11, 2011

Key facts

NPI
1831254622
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4628 (NV)
Practice address
1101 West Moana Lane
Ste 4
Reno, NV 89509-4795
Phone
(775) 825-9353
Fax
(775) 825-9397
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160413002317 NV Order and Referring Only - Dentist
Practitioner - Dentist
3870891500

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4628 NV Yes

Addresses

Primary practice location

1101 West Moana Lane
Ste 4
Reno, NV 89509-4795

Mailing address

6580 South McCarran Blvd
Ste B
Reno, NV 89509-6140
Phone (775) 825-9353

Other providers in Reno, NV

All providers in Reno, NV · General Practice Dentistry in Nevada

Sources for this page

Verify at the official NPI Registry.