Provider Demographics
NPI:1538947221
Name:STAGE-ROSENBERG, JULIE ANN (RDH, MPH)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:STAGE-ROSENBERG
Suffix:
Gender:F
Credentials:RDH, MPH
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:STAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:2357 ISABELLA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-2305
Mailing Address - Country:US
Mailing Address - Phone:775-842-0874
Mailing Address - Fax:
Practice Address - Street 1:825 S. MAIN STREET
Practice Address - Street 2:TONOPAH DENTAL CENTER
Practice Address - City:TONOPAH
Practice Address - State:NV
Practice Address - Zip Code:89049
Practice Address - Country:US
Practice Address - Phone:775-477-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2560124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist