Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tahoe Facial Plastic Surgery PLLC

Organization Dermatology Physician · NPI 1730914433

Tahoe Facial Plastic Surgery PLLC is a Dermatology Physician in Carson City, Nevada. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1600 Medical Pkwy
Carson City, NV 89703-4625
Phone: (530) 721-6052
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Facial Plastic Surgery Physician (primary) Taxonomy 207YS0123X
Dermatology Physician Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Plastic Surgery Physician Taxonomy 208200000X

Record details

NPI number1730914433
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Benjamin Bradford — Ceo · (808) 936-3090
Other names Tahoe Facial Plastic Surgery
NPI enumeratedSeptember 4, 2024
Last updated in NPPESSeptember 4, 2024
Certification dateSeptember 4, 2024
Mailing addressPo Box 11195, Zephyr Cove, NV 89448-3195

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