Healthcare Provider Details

I. General information

NPI: 1659599280
Provider Name (Legal Business Name): GURPREET SINGH KHAIRAH D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8460 S EASTERN AVE
LAS VEGAS NV
89123-2864
US

IV. Provider business mailing address

8460 S EASTERN AVE
LAS VEGAS NV
89123-2864
US

V. Phone/Fax

Practice location:
  • Phone: 702-270-0025
  • Fax:
Mailing address:
  • Phone: 702-270-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5477
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number54663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: