Healthcare Provider Details

I. General information

NPI: 1184135147
Provider Name (Legal Business Name): XUAN-THU THI LOVELL RDH, OMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: XUAN-THU THI FAILING RDH, OMT

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 BATHGATE CT
RENO NV
89519-0951
US

IV. Provider business mailing address

4790 CAUGHLIN PARKWAY STE #357
RENO NV
89519
US

V. Phone/Fax

Practice location:
  • Phone: 775-544-5751
  • Fax:
Mailing address:
  • Phone: 775-453-6833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number101675
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberRDH25574
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number101675
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberRDH25574
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number101675
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH25574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: