Provider Demographics
NPI:1386913309
Name:APEX ENDODONTICS OF LAS VEGAS
Entity type:Organization
Organization Name:APEX ENDODONTICS OF LAS VEGAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:TAILUNG
Authorized Official - Last Name:TAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-683-6266
Mailing Address - Street 1:2337 E BONANZA RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-3418
Mailing Address - Country:US
Mailing Address - Phone:702-723-9808
Mailing Address - Fax:702-723-9818
Practice Address - Street 1:2337 E BONANZA RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-3418
Practice Address - Country:US
Practice Address - Phone:702-723-9808
Practice Address - Fax:702-723-9818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS7-59261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental