MEDICARE: STOKES DENTISTS OF SPRING VALLEY, PC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1548712193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOKES DENTISTS OF SPRING VALLEY, PC

Provider Business Mailing Address
First Line	:	17000 RED HILL AVE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-5626
Country	:	US
Telephone Number	:	714-845-8890
Fax Number	:	949-474-1495

Provider Business Practice Location Address
First Line	:	5270 S FORT APACHE RD
Second Line	:	SUITE 340
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1724
Country	:	US
Telephone Number	:	702-273-3404
Fax Number	:	702-357-3097

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROSS F STOKES
Credential	:	DDS
Telephone Number	:	702-273-3404

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	10/31/2016

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