Provider Demographics
NPI:1073973384
Name:AARON REEVES, REEVES DENTAL CORPORATION
Entity Type:Organization
Organization Name:AARON REEVES, REEVES DENTAL CORPORATION
Other - Org Name:SACRAMENTO VALLEY DENTAL SPECIALISTS 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHURKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-320-7587
Mailing Address - Street 1:PO BOX 19669
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-0669
Mailing Address - Country:US
Mailing Address - Phone:916-821-1416
Mailing Address - Fax:
Practice Address - Street 1:2277 FAIR OAKS BLVD STE 330
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5596
Practice Address - Country:US
Practice Address - Phone:916-821-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty