Healthcare Provider Details

I. General information

NPI: 1245311083
Provider Name (Legal Business Name): SCOTT D. JARRETT, SIERRA ENDODONTICS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9456 DOUBLE R BLVD SUITE A
RENO NV
89521-5977
US

IV. Provider business mailing address

9456 DOUBLE R BLVD SUITE A
RENO NV
89521-5977
US

V. Phone/Fax

Practice location:
  • Phone: 775-851-4222
  • Fax: 775-851-4321
Mailing address:
  • Phone: 775-851-4222
  • Fax: 775-851-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberS7-37
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberS7-40
License Number StateNV

VIII. Authorized Official

Name: DR. SCOTT DAVID JARRETT
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 775-851-4222