# CPD SOUTH MEADOWS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891441762
- **Authorized official:** JASON CHAMPAGNE DDS (OWNER)
- **Authorized official phone:** (775) 636-9939

## Contact information

- **Practice address:** 5435 KIETZKE LN STE 100, RENO, NV 89511-1088
- **Practice address phone:** (775) 237-2038
- **Practice address fax:** (775) 359-4034
- **Mailing address:** 255 GLENDALE AVE STE 3, SPARKS, NV 89431-5777
- **Mailing address phone:** (775) 636-9939
- **Mailing address fax:** (775) 737-4002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2022
- **Last updated:** 08/30/2023