Healthcare Provider Details

I. General information

NPI: 1104788140
Provider Name (Legal Business Name): KUYKENDAHL FAMILY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2025
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 FM 2920 RD
SPRING TX
77379-2542
US

IV. Provider business mailing address

6002 FM 2920 RD
SPRING TX
77379-2542
US

V. Phone/Fax

Practice location:
  • Phone: 281-783-2273
  • Fax:
Mailing address:
  • Phone: 281-783-2273
  • Fax: 281-947-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SANGHEE YUN
Title or Position: DDS
Credential:
Phone: 281-825-9500