# KELLY JIN, D.M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Icon Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033341342
- **Authorized official:** DR. KELLY S. JIN DMD (DENTIST/OWNER)
- **Authorized official phone:** (702) 804-4266

## Contact information

- **Practice address:** 3730 E. FLAMINGO RD., LAS VEGAS, NV 89121
- **Practice address phone:** (702) 804-4266
- **Practice address fax:** (702) 435-1222
- **Mailing address:** 7300 ARROYO CROSSING PARKWAY, \#100, LAS VEGAS, NV 89113
- **Mailing address phone:** (702) 880-4266
- **Mailing address fax:** (702) 792-4266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3739 | NV | Yes |

## Other

- **Enumeration date:** 08/20/2009
- **Last updated:** 08/20/2009