Provider Demographics
NPI:1326614793
Name:HELEN M NGHIEM, OD, PC
Entity type:Organization
Organization Name:HELEN M NGHIEM, OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KNISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-321-8536
Mailing Address - Street 1:4300 MEADOWS LN STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3018
Mailing Address - Country:US
Mailing Address - Phone:702-822-6003
Mailing Address - Fax:
Practice Address - Street 1:4300 MEADOWS LN STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3018
Practice Address - Country:US
Practice Address - Phone:702-822-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2502003Medicaid