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General NPI Number Information
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NPI Number | 1740015080
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Entity Type | Individual
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Provider Name | JAMES PENNINGTON
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Gender | Male
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 280 VISTA KNOLL PKWY STE 114
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City | RENO
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State | NV
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Zip | 89506-5649
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Country | US
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Telephone | 775-971-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 DAMONTE RANCH PKWY UNIT 3149
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City | RENO
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State | NV
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Zip | 89521-4557
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 8106
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License Number State | NV
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