MEDICARE: ESTHER JANG

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-389	NV

General Provider Information

NPI Number	:	1487236857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER JANG

Provider Business Mailing Address
First Line	:	4471 DEAN MARTIN DR UNIT 3016
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4246
Country	:	US
Telephone Number	:	628-226-7402
Fax Number	:

Provider Business Practice Location Address
First Line	:	4471 DEAN MARTIN DR UNIT 3106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4246
Country	:	US
Telephone Number	:	628-226-7402
Fax Number	:

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

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	10/07/2024

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