Provider Demographics
NPI:1922112127
Name:ANACKER, JOYCE CAROL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:CAROL
Last Name:ANACKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3477 SKYLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5678
Mailing Address - Country:US
Mailing Address - Phone:952-933-8505
Mailing Address - Fax:
Practice Address - Street 1:3575 GRANT DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5301
Practice Address - Country:US
Practice Address - Phone:775-825-6484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4692T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice