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General NPI Number Information
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NPI Number | 1073186946
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Entity Type | Individual
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Provider Name | KIM NHUNG KHA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 15950 ELDORADO PKWY STE 100
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City | FRISCO
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State | TX
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Zip | 75035-5816
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Country | US
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Telephone | 972-540-9977
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 ROUTH CREEK PKWY APT 7201
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City | RICHARDSON
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State | TX
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Zip | 75082-0171
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37569
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License Number State | TX
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