MEDICARE: VIRGINIA SUAREZ 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	5957	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5957	OTHER	NV	DENTAL LICENSE

General Provider Information

NPI Number	:	1033296652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA SUAREZ DMD

Provider Business Mailing Address
First Line	:	1070 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1008
Country	:	US
Telephone Number	:	702-648-3701
Fax Number	:	702-648-7343

Provider Business Practice Location Address
First Line	:	1070 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1008
Country	:	US
Telephone Number	:	702-648-3701
Fax Number	:	702-648-7343

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/21/2022

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Directions to “ VIRGINIA SUAREZ DMD” Practice Location

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