Healthcare Provider Details

I. General information

NPI: 1780359794
Provider Name (Legal Business Name): XCELA CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4360 SLIDE MOUNTAIN CIR
RENO NV
89511-9530
US

IV. Provider business mailing address

4360 SLIDE MOUNTAIN CIR
RENO NV
89511-9530
US

V. Phone/Fax

Practice location:
  • Phone: 775-453-0142
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: VERONIKA VAZQUEZ
Title or Position: DOCTOR/OWNER
Credential: DDS
Phone: 775-453-0142