NPI 1114454097 · live from the CMS NPI Registry
Legendary Smiles Orthodontics LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Reno, NV. National Provider Identifier 1114454097, active.
NPI record
| NPI | 1114454097 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 5220 Neil Rd., Ste. 110, Reno, NV 89502 |
| Practice phone | 775-336-1510 |
| Mailing address | 3605 Grant Dr, Reno, NV 89509 |
| Enumerated | May 22, 2017 |
| Last updated | March 17, 2018 |
| Authorized official | Nate Rockwell, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.