Provider Demographics
NPI:1073398251
Name:SAMIANO, BEANCA JHANINE MULATO (DMD)
Entity Type:Individual
Prefix:DR
First Name:BEANCA JHANINE
Middle Name:MULATO
Last Name:SAMIANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 INFINITY BAY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5314
Mailing Address - Country:US
Mailing Address - Phone:702-985-7939
Mailing Address - Fax:
Practice Address - Street 1:2647 INFINITY BAY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5314
Practice Address - Country:US
Practice Address - Phone:702-985-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV78671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice