Wang Blue Diamond Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WANG BLUE DIAMOND MODERN DENTISTRY, PC

Doing business as

Blue Diamond Modern Dentistry

Practice address

6980 Blue Diamond Rd, Ste D-110
Las Vegas, NV 89178

Phone

(702) 760-7912

Fax

(702) 800-4801

NPI assigned

Aug 20, 2026

Last updated

Sep 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vincent Mu-Shyuan Wang, DMD

Title

Owner

Phone

(702) 760-7912

Specialties & licenses 1

Addresses

Other names 1

• Blue Diamond Modern Dentistry Doing business as

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

{
    "created_epoch": "1787184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1821904715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 BLUE DIAMOND RD, STE D-110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89178",
            "telephone_number": "702-760-7912",
            "fax_number": "702-800-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANG BLUE DIAMOND MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-20",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "MU-SHYUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-760-7912",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Diamond Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Wan, PHARMD
• Tiffany Wan, R.D.
• Wandering Minds Behavioral LLC
• Wandering Pine Wellness PLLC
• Jeanetta Wandick
• Wang Sleep Clinic, PLLC
• Yi Ting Wang Tate
• Ada Wang
• Apple Yun Wang
• Charles Wang, DO

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.