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General NPI Number Information
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NPI Number | 1669114245
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Entity Type | Individual
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Provider Name | ANNA KAY ROMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 1700 W CHARLESTON BLVD BLDG A
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City | LAS VEGAS
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State | NV
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Zip | 89102-2335
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Country | US
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Telephone | 702-774-2417
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Fax |
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Provider Business Mailing Address
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Address Line | 320 SOUTHDALE ST SE
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City | SLEEPY EYE
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State | MN
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Zip | 56085-1875
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Country | US
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Telephone | 507-227-0187
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7669
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License Number State | NV
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