1235556770 NPI number — ARETE DENTAL LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235556770 NPI number — ARETE DENTAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARETE DENTAL LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTH HILLS DENTAL GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235556770
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1055 N HILLS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89506-8802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-677-1055
Provider Business Mailing Address Fax Number:
775-677-1081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1055 N HILLS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89506-8802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-677-1055
Provider Business Practice Location Address Fax Number:
775-677-1081
Provider Enumeration Date:
03/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GORSUCH
Authorized Official First Name:
RHONDA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
PRACTICE ADMIN
Authorized Official Telephone Number:
775-677-1055

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  4747 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1568586881 . This is a "SINGLE NPI" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".