Provider Demographics
NPI:1619302353
Name:SILVA, JESSICA ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:SILVA
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 1:1005 WIGWAM PKWY
Mailing Address - Street 2:APT. 24106
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8247
Mailing Address - Country:US
Mailing Address - Phone:559-288-5377
Mailing Address - Fax:
Practice Address - Street 1:710 CORONADO CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4289
Practice Address - Country:US
Practice Address - Phone:702-260-0102
Practice Address - Fax:702-260-0881
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL120121223P0300X
NV67971223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics