MEDICARE: DR. ERYN ENCE 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3274	NV
2	122300000X	Dentist	6440	OK

General Provider Information

NPI Number	:	1427499888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERYN ENCE DMD

Provider Business Mailing Address
First Line	:	123 NE 2ND ST APT 451
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-2269
Country	:	US
Telephone Number	:	405-271-4148
Fax Number	:

Provider Business Practice Location Address
First Line	:	8490 S EASTERN AVE STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2806
Country	:	US
Telephone Number	:	702-260-8241
Fax Number	:	702-260-8251

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

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	07/06/2022

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