Healthcare Provider Details

I. General information

NPI: 1245150739
Provider Name (Legal Business Name): AMY NICOLE DANG LICENSED OPTICIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5260 W 7TH ST
RENO NV
89523-2332
US

IV. Provider business mailing address

5260 W 7TH ST
RENO NV
89523-2332
US

V. Phone/Fax

Practice location:
  • Phone: 775-624-2085
  • Fax: 775-624-2087
Mailing address:
  • Phone: 775-624-2085
  • Fax: 775-624-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number835
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: