Provider Demographics
NPI:1811721970
Name:SEAVER, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:SEAVER
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 1:1745 LAUREL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-3874
Mailing Address - Country:US
Mailing Address - Phone:302-463-9071
Mailing Address - Fax:
Practice Address - Street 1:1745 LAUREL RIDGE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3874
Practice Address - Country:US
Practice Address - Phone:302-463-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4466124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist