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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TAE JEONG GONG DMD
NPI 1790463883
Dentist - General Practice in Henderson, NV

Active since July 07, 2023
366 W LAKE MEAD PKWY STE 100, HENDERSON, NV 89015(702) 464-3090 Get Directions Write a Review

NPPES record last updated: October 22, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Tae Jeong Gong Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TAE JEONG GONG DMD (NPI 1790463883) is an individual general practice provider in Henderson, Nevada, licensed in Nevada (8381) and active in the NPI registry since July 2023.

NPPES Registry Identity

NPI1790463883
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. TAE JEONG GONGCredential: DMD
Location Address366 W LAKE MEAD PKWY STE 100Henderson, NV 89015-7287
Mailing Address366 W Lake Mead Pkwy Ste 100Henderson, NV 89015-7287
Phone(702) 464-3090
Sole ProprietorYes
Enumeration DateJuly 7, 2023
Last NPPES UpdateOctober 22, 2026
NPPES CertifiedOctober 22, 2026
✔ NPI 1790463883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NV · 8381
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
366 W LAKE MEAD PKWY STE 100, Henderson, NV 89015
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross and Blue Shield of Montana and more.Insurance ›

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JERMAINE MICHAEL WALLS DDS
Dentist (General Practice)
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3158
DR. RITA YU DMD
Dentist
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (347) 844-1210
DR. WILLIAM JUN DMD
Dentist (General Practice)
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090
DR. MANDY MUN-YIN YIP DDS
Dentist (General Practice)
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090
VICTORIA QUIZON DMD
Dentist
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090
PAUL MARTIN GUTIERREZ DDS
Dentist (General Practice)
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090
MUGLESTON HENDERSON MODERN DENTISTRY, PC
Dentist (General Practice)
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090
ALLEN CLARK TANG DMD
Dentist
366 W LAKE MEAD PKWY STE 100
HENDERSON, NV 89015
Clark County (702) 464-3090

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tae Jeong Gong's NPI number?

The NPI number for Tae Jeong Gong is 1790463883. It was assigned to this individual provider in the NPPES registry on July 7, 2023.

Where is Tae Jeong Gong located?

Tae Jeong Gong practices at 366 W Lake Mead Pkwy Ste 100, Henderson, NV 89015. The listed phone number is (702) 464-3090.

What is Tae Jeong Gong's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Tae Jeong Gong accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Tae Jeong Gong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tae Jeong Gong was last updated on October 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.