NPI 1821753047 · live from the CMS NPI Registry
Jason Champagne Iii PLLC
Clinic/Center, Dental in Reno, NV. National Provider Identifier 1821753047, active.
NPI record
| NPI | 1821753047 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Dental 261QD0000X |
| Practice location | 175 Brinkby Ave, Reno, NV 89509 |
| Practice phone | 775-636-9939 |
| Mailing address | 255 Glendale Ave Ste 3, Sparks, NV 89431 |
| Enumerated | November 2, 2021 |
| Last updated | November 9, 2021 |
| Authorized official | Jason Champagne, Member |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — |
| Clinic/Center, Dental primary | 261QD0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.