MEDICARE: DR. SIERRA NORVELL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30.028213	OH
2	1223G0001X	General Practice Dentistry	19089	MD

General Provider Information

NPI Number	:	1013887108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIERRA NORVELL DMD

Provider Business Mailing Address
First Line	:	3740 SALEM AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-1630
Country	:	US
Telephone Number	:	937-278-9126
Fax Number	:

Provider Business Practice Location Address
First Line	:	3740 SALEM AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-1630
Country	:	US
Telephone Number	:	937-278-9126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	03/16/2026

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