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General NPI Number Information
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NPI Number | 1831266147
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Entity Type | Individual
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Provider Name | CARIANN ELAINE CHAMPAGNE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 1125 AVENUE OF THE OAKS UNIT 161
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City | SPARKS
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State | NV
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Zip | 89431-4913
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Country | US
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Telephone | 775-335-3199
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Fax | 775-870-1632
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Provider Business Mailing Address
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Address Line | 1125 AVENUE OF THE OAKS UNIT 161
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City | SPARKS
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State | NV
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Zip | 89431-4913
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Country | US
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Telephone | 775-335-3199
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Fax | 775-870-1632
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 4049
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License Number State | NV
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