Provider Demographics
NPI:1922683754
Name:RICHARDS, JOYCE ELLEN (RDH, BSDH)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ELLEN
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4540
Mailing Address - Country:US
Mailing Address - Phone:530-305-7323
Mailing Address - Fax:
Practice Address - Street 1:2261 PYRAMID WAY STE 7
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-8798
Practice Address - Country:US
Practice Address - Phone:775-331-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH11908124Q00000X
NV102359124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV102359Other124Q00000X
CA11908Other124Q00000X