Individual provider Active NPI

Nicole Phuong Lam, D.M.D.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1083879258
Registry record updated Jul 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5730 Issued in NV
Practice address
4343 N Rancho Dr Ste 131
Las Vegas, NV 89130-3422
Phone
(702) 395-7200
NPI assigned
Jul 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5730 NV Primary

Addresses

Primary practice location

4343 N Rancho Dr Ste 131
Las Vegas, NV 89130-3422

Mailing address

7277 Sashaying Spirit CT
Las Vegas, NV 89131-2356
Phone (702) 328-8349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5730NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gussow Dental Care Prof Corp General Practice PastSince Feb 23, 2025 Accepting new patients
Sleep Apnea Therapy Nevada PastSince Feb 16, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217116800000",
    "number": "1083879258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7277 SASHAYING SPIRIT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312356",
            "telephone_number": "702-328-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 N RANCHO DR STE 131",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303422",
            "telephone_number": "702-395-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "NICOLE",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-27",
        "last_updated": "2008-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.