# FLAMINGO RD NIELSON PDC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kohlmeyer Dental of Las Vegas
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588454367
- **Authorized official:** MARK CHRISTENSEN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (801) 305-3460

## Contact information

- **Practice address:** 5680 W FLAMINGO RD STE B, LAS VEGAS, NV 89103-2339
- **Practice address phone:** (702) 367-1499
- **Practice address fax:** (702) 367-2531
- **Mailing address:** 727 E UTAH VALLEY DR, AMERICAN FORK, UT 84003-3345
- **Mailing address phone:** (801) 305-3460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 05/07/2025
- **Last updated:** 05/07/2025