MEDICARE: DR. KENNY K CHEUNG D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	057565	NY

General Provider Information

NPI Number	:	1013270057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNY K CHEUNG D.D.S

Provider Business Mailing Address
First Line	:	8465 W SAHARA AVE STE 111
Second Line	:	UNIT 1456
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8902
Country	:	US
Telephone Number	:	970-325-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 S RAMPART BLVD STE 360
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5730
Country	:	US
Telephone Number	:	702-228-2218
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2012
Last Update Date	:	02/06/2026

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