Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1811102403 Deactivated / Inactive NPI Female Practitioner

Dr. Kelly J Jin , DMD

Dentist • Las Vegas, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kelly Jin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 14, 2007
NPI Deactivation Date October 14, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Jin, DMD was a registered Dentist practicing in Las Vegas, NV. Throughout an active medical career spanning 13 years, Dr. Jin provided care at the practice location at 1780 N BUFFALO DR until profile deactivation on 2020-10-14.

Practice Location & Contact Primary Location

Practice Address

1780 N Buffalo Dr
#109

Las Vegas, NV 89128

Telephone 7027960808
Fax 7023410809
Associated Practice Facility / Clinic
🏢 Peak Condition, Llc Facility NPI 1528194610

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Las Vegas, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 30.0 Yrs
Regional Practice Density
511 Specialists

Practicing in Las Vegas, NV (886 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License NV 3739

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Richard Chen , DMD

Dentist - General Practice

NPI 1235104415

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 14, 2020

Record deactivated on October 14, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1780 N BUFFALO DR, #109, LAS VEGAS, NV 89128 (Tel: 7027960808)

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Updated Business Mailing Address July 08, 2007

Registered at 6040 S RAINBOW BLVD, #2, LAS VEGAS, NY 89118 (Tel: 7028804266)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KELLY JIN, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #3739 in NV)

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Initial NPI Registration & Enumeration May 14, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811102403
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2007
Last Update: July 08, 2007
Deactivation Date: October 14, 2020

Mailing Address

6040 S Rainbow Blvd, #2

Las Vegas, NY 89118

Phone: 7028804266

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.