Provider Demographics
NPI:1760673966
Name:LAMBORN, VERNON JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:JOHN
Last Name:LAMBORN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 S EASTERN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2856
Mailing Address - Country:US
Mailing Address - Phone:702-451-9111
Mailing Address - Fax:702-451-9962
Practice Address - Street 1:8440 S EASTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2856
Practice Address - Country:US
Practice Address - Phone:702-451-9111
Practice Address - Fax:702-451-9962
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist