Active NPI
Yeam El Dorado Modern Dentistry, PC
- General Practice Dentistry
- North Las Vegas, NV
National Provider Identifier
1841959673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- YEAM EL DORADO MODERN DENTISTRY, PC
- Practice address
- 5514 Camino Al Norte Ste A2
North Las Vegas, NV 89031-0807 - Phone
- (702) 827-1352
- NPI assigned
- Dec 9, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Inyoung Yeam
- Title
- Owner
- Phone
- (714) 845-8500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
5514 Camino Al Norte Ste A2
North Las Vegas, NV 89031-0807
Mailing address
PO Box 920050
Dallas, TX 75392-0050
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2264109 | El Dorado Modern Dentistry | Certificate of waiver | Jul 10, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- North Las Vegas, NV
- NPI 1619669744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639008000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639008000000",
"number": "1841959673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 920050",
"city": "DALLAS",
"state": "TX",
"postal_code": "753920050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5514 CAMINO AL NORTE STE A2",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890310807",
"telephone_number": "702-827-1352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YEAM EL DORADO MODERN DENTISTRY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-12-09",
"last_updated": "2021-12-09",
"certification_date": "2021-12-09",
"status": "A",
"authorized_official_last_name": "YEAM",
"authorized_official_first_name": "INYOUNG",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "714-845-8500"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.