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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.

MR. TAE JEONG GONG
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: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Tae Jeong Gong NPPES

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

MR. TAE JEONG GONG (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 NameMR. TAE JEONG GONG
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 UpdateJune 24, 2026
NPPES CertifiedJune 24, 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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Other Providers at the Same Location NPPES 13

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

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
PATRICK ANGHEL DDS
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.

When was this NPI record last updated?

The NPPES record for Tae Jeong Gong was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 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.