Provider Demographics
NPI:1184351314
Name:NGHIEM, BAO-LINH TASHA (DMD)
Entity type:Individual
Prefix:DR
First Name:BAO-LINH TASHA
Middle Name:
Last Name:NGHIEM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TASHA
Other - Middle Name:
Other - Last Name:NGHIEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:4954 BOULDER HWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4954 BOULDER HWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3016
Practice Address - Country:US
Practice Address - Phone:702-847-6273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist