MEDICARE: TANYA STEVENS 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	122300000X	Dentist	49997	CA
2	122300000X	Dentist	4364	NV

General Provider Information

NPI Number	:	1821186164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA STEVENS DDS

Provider Business Mailing Address
First Line	:	7580 NORMAN ROCKWELL LN STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-6019
Country	:	US
Telephone Number	:	702-202-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	7580 NORMAN ROCKWELL LN STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-6019
Country	:	US
Telephone Number	:	702-202-3400
Fax Number	:	702-202-6800

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/01/2021

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Directions to “ TANYA STEVENS DDS” Practice Location

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