MEDICARE: FATIMA NEPACENA 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	7388	NV

General Provider Information

NPI Number	:	1992318463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA NEPACENA DMD

Provider Business Mailing Address
First Line	:	8235 LANTANA SPRINGS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-4717
Country	:	US
Telephone Number	:	408-836-5709
Fax Number	:

Provider Business Practice Location Address
First Line	:	6740 S FORT APACHE RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5399
Country	:	US
Telephone Number	:	702-736-7979
Fax Number	:

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

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	03/15/2023

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