Healthcare Provider Details

I. General information

NPI: 1669444097
Provider Name (Legal Business Name): ROBERT M SVARNEY JR. D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8084 WEST SAHARA AVE SUITE F
LAS VEGAS NV
89117
US

IV. Provider business mailing address

11830 TEVARE LN UNIT 2061 SUITE 2061
LAS VEGAS NV
89138-4598
US

V. Phone/Fax

Practice location:
  • Phone: 702-540-4256
  • Fax:
Mailing address:
  • Phone: 702-540-4256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number55464
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberS287C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: