Basic Information
| Provider Information | |||||||||
| NPI: | 1871104455 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAM | ||||||||
| FirstName: | STEVEN | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9258 DESERT HEAT AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891786219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022665497 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9516 W FLAMINGO RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891475750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022543135 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2020 | ||||||||
| LastUpdateDate: | 08/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 7371 | NV | Y | Dental Providers | Dentist | General Practice |
No ID Information.