Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Tae Jeong Gong

Individual provider General Practice Dentistry · NPI 1790463883

Mr. Tae Jeong Gong is a General Practice Dentistry in Henderson, Nevada. Practices as a sole proprietor. Licensed in Nevada.

Licensed in
NV
In the registry since
2023

Practice location Address checks out

366 W Lake Mead Pkwy Ste 100
Henderson, NV 89015-7287
Phone: (702) 464-3090
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 8381 (NV)

Record details

NPI number1790463883
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 7, 2023
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026

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