Provider Demographics
NPI:1508988940
Name:TALANCON, JOSE F (DDS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:F
Last Name:TALANCON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PYRAMID WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5059
Mailing Address - Country:US
Mailing Address - Phone:775-356-8251
Mailing Address - Fax:775-356-7041
Practice Address - Street 1:630 PYRAMID WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5059
Practice Address - Country:US
Practice Address - Phone:775-356-8251
Practice Address - Fax:775-356-7041
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice