Healthcare Provider Details

I. General information

NPI: 1609468339
Provider Name (Legal Business Name): ARLENE MEREDITH D NAGANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 I ST
SPARKS NV
89431-3689
US

IV. Provider business mailing address

850 I ST
SPARKS NV
89431-3689
US

V. Phone/Fax

Practice location:
  • Phone: 775-358-5330
  • Fax: 775-358-5344
Mailing address:
  • Phone: 775-358-5330
  • Fax: 775-358-5344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: