Provider Demographics
NPI:1174226658
Name:ANIKA RODGERS I, PLLC
Entity type:Organization
Organization Name:ANIKA RODGERS I, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-636-9939
Mailing Address - Street 1:255 GLENDALE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5777
Mailing Address - Country:US
Mailing Address - Phone:775-636-9939
Mailing Address - Fax:
Practice Address - Street 1:1125 AVENUE OF THE OAKS UNIT 101
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4913
Practice Address - Country:US
Practice Address - Phone:775-446-4380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty