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General NPI Number Information
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NPI Number | 1619302353
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Entity Type | Individual
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Provider Name | JESSICA ANN SILVA DMD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 710 CORONADO CENTER DR SUITE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4289
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Country | US
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Telephone | 702-260-0102
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Fax | 702-260-0881
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Provider Business Mailing Address
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Address Line | 1005 WIGWAM PKWY APT. 24106
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City | HENDERSON
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State | NV
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Zip | 89074-8247
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Country | US
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Telephone | 559-288-5377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DL12012
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 6797
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License Number State | NV
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