Provider Demographics
NPI:1114131224
Name:SMERDON, JAMES P (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:SMERDON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 S TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-5804
Mailing Address - Country:US
Mailing Address - Phone:775-423-7400
Mailing Address - Fax:775-423-7410
Practice Address - Street 1:1241 S TAYLOR ST
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-5804
Practice Address - Country:US
Practice Address - Phone:775-423-7400
Practice Address - Fax:775-423-7410
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVGR4512T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice