| Jason Champagne Ii Pllc | |
|
601 W Moana Ln Ste 6 Reno NV 89509-4959 | |
| (775) 636-9939 | |
| Not Available |
| Full Name | Jason Champagne Ii Pllc |
|---|---|
| Speciality | Dentist |
| Location | 601 W Moana Ln Ste 6, Reno, Nevada |
| Authorized Official Name and Position | Jason Champagne (OWNER) |
| Authorized Official Contact | 7756369939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Champagne Ii Pllc 601 W Moana Ln Ste 6 Reno NV 89509-4959 Ph: (775) 583-7755 | Jason Champagne Ii Pllc 601 W Moana Ln Ste 6 Reno NV 89509-4959 Ph: (775) 636-9939 |
| NPI Number | 1538835871 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 10/15/2021 |
| Medicare PECOS PAC ID | 5193114601 |
|---|---|
| Medicare Enrollment ID | O20211122001824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538835871 | NPI | - | NPPES |
| Provider Name | Shanna Kyungmi Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710282272 PECOS PAC ID: 9032370465 Enrollment ID: I20211122002238 |
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