Acevedo, Jason Randall

Acevedo, Jason Randall is an individual health care provider with primary practice located at 3461 Lake Tahoe Blvd #1, South Lake Tahoe CA 96150. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Acevedo, Jason Randall can be contacted via phone (530) 544-1050.

Contact Information

Primary practice address
3461 Lake Tahoe Blvd #1 South Lake Tahoe CA 96150
Phone: (530) 544-1050
Fax: (530) 544-1709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 51539 California

Profile Details

NPI number 1326127663
LBN Legal business name Acevedo, Jason Randall
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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