MEDICARE: HARMONY PEDIATRIC DENTAL GROUP LLC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1316881378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY PEDIATRIC DENTAL GROUP LLC

Provider Business Mailing Address
First Line	:	9785 GATEWAY DR STE 2000
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89521-2992
Country	:	US
Telephone Number	:	775-409-4614
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 NW 38TH AVE STE 101
Second Line	:
City	:	CAMAS
State	:	WA
Zip	:	98607-5405
Country	:	US
Telephone Number	:	360-953-8887
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	ALETA BEUTER
Credential	:
Telephone Number	:	775-409-4614

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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