Provider Demographics
NPI:1275660557
Name:NG, KANT (OD)
Entity Type:Individual
Prefix:DR
First Name:KANT
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 W CRAIG RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0234
Mailing Address - Country:US
Mailing Address - Phone:702-368-2021
Mailing Address - Fax:702-368-2023
Practice Address - Street 1:1513 W CRAIG RD
Practice Address - Street 2:STE 1
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0234
Practice Address - Country:US
Practice Address - Phone:702-368-2021
Practice Address - Fax:702-368-2023
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist