Provider Demographics
NPI:1336836550
Name:JESSICA DENNIS OD PC
Entity Type:Organization
Organization Name:JESSICA DENNIS OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-354-0400
Mailing Address - Street 1:2855 N MCCARRAN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1887
Mailing Address - Country:US
Mailing Address - Phone:775-354-0400
Mailing Address - Fax:775-502-4552
Practice Address - Street 1:2855 N MCCARRAN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1887
Practice Address - Country:US
Practice Address - Phone:775-354-0400
Practice Address - Fax:775-502-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty