MEDICARE: DR. CARMEN ARACELY FERNANDEZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	S7-27	NV

General Provider Information

NPI Number	:	1447409339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMEN ARACELY FERNANDEZ DDS

Provider Business Mailing Address
First Line	:	1811 SOUTH RAINBOW BLVD
Second Line	:	STE. 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-889-1880
Fax Number	:	702-256-7912

Provider Business Practice Location Address
First Line	:	1811 SOUTH RAINBOW BLVD
Second Line	:	STE. 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-889-1880
Fax Number	:	702-256-7912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	09/16/2008

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