MEDICARE: ANA LAURA GONZALEZ LAZO 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	106S00000X	Behavior Technician	RBT6377	NV
2	124Q00000X	Dental Hygienist

General Provider Information

NPI Number	:	1487512794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA LAURA GONZALEZ LAZO DDS

Provider Business Mailing Address
First Line	:	4616 W SAHARA AVENUE STE 480
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3654
Country	:	US
Telephone Number	:	702-530-3026
Fax Number	:

Provider Business Practice Location Address
First Line	:	4616 W SAHARA AVENUE STE 480
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3654
Country	:	US
Telephone Number	:	702-530-3026
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	03/24/2026

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