MEDICARE: KIMBERLY PEARL LAO YAP DDS

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	122300000X	Dentist	6509	NV

General Provider Information

NPI Number	:	1255615803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY PEARL LAO YAP DDS

Provider Business Mailing Address
First Line	:	6720 N HUALAPAI WAY STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1373
Country	:	US
Telephone Number	:	702-850-5252
Fax Number	:	702-470-1888

Provider Business Practice Location Address
First Line	:	6720 N HUALAPAI WAY STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1373
Country	:	US
Telephone Number	:	702-850-5252
Fax Number	:	702-470-1888

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

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	06/15/2020

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