Provider Demographics
NPI:1356682124
Name:ROZANSKI, JILLIAN (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:ROZANSKI
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 SPARKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-7930
Mailing Address - Country:US
Mailing Address - Phone:775-237-2038
Mailing Address - Fax:
Practice Address - Street 1:735 SPARKS BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434
Practice Address - Country:US
Practice Address - Phone:775-237-2038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314631223S0112X
NVS2-190C204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery