Healthcare Provider Details

I. General information

NPI: 1942115514
Provider Name (Legal Business Name): HAEMIN JANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 DAMONTE RANCH PKWY STE F
RENO NV
89521-2989
US

IV. Provider business mailing address

59 DAMONTE RANCH PKWY STE F
RENO NV
89521-2989
US

V. Phone/Fax

Practice location:
  • Phone: 775-851-2204
  • Fax:
Mailing address:
  • Phone: 775-851-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8485
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: