Provider Demographics
NPI:1790188068
Name:BESSO, CODY LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:LEE
Last Name:BESSO
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 1:1500 W HUFFAKER LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-7558
Mailing Address - Country:US
Mailing Address - Phone:775-842-4071
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:89434-7930
Practice Address - Country:US
Practice Address - Phone:775-359-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist