Provider Demographics
NPI:1750169827
Name:JUAREZ-VILLANUEVA, PAMELA
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:JUAREZ-VILLANUEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GEIGER GRADE RD UNIT 1136
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8649
Mailing Address - Country:US
Mailing Address - Phone:530-386-8188
Mailing Address - Fax:
Practice Address - Street 1:517 HAMMILL LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1004
Practice Address - Country:US
Practice Address - Phone:775-824-2323
Practice Address - Fax:775-824-2324
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant