Kevin Tan DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KEVIN TAN DDS LLC

Practice address

4205 S Grand Canyon Dr Ste 19
Las Vegas, NV 89147-7152

Phone

(702) 805-1117

Fax

(702) 805-1180

NPI assigned

Aug 19, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Tan, DDSNPI 1356913487

Title

Owner Dentist

Phone

(702) 805-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Tan, DDS

  • Dentist
  • Las Vegas, NV
  • NPI 1356913487
  NPD Authorized official

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1962389106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 S GRAND CANYON DR STE 19",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477152",
            "telephone_number": "702-805-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 S GRAND CANYON DR STE 19",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477152",
            "telephone_number": "702-805-1117",
            "fax_number": "702-805-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN TAN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "702-805-1117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "7778",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin L Kaldy DC PC
• Kevin L. White
• Kevin P. Debiparshad PLLC
• Kevin P. Sinai DO LTD
• Kevin Rayls, M.D., Professional Corporation
• Kevin Thomas Bahoora Advanced Spine and Wellness
• James R Kew, CRNA
• Key Rose, LLC
• Ashley Key
• Constance Knight Key, MFT, LCADC

• 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 Aug 19, 2025; 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.