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General NPI Number Information
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NPI Number | 1376645101
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Entity Type | Individual
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Provider Name | HEDA KOH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15827 LOS GATOS BLVD # B
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City | LOS GATOS
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State | CA
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Zip | 95032-3314
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Country | US
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Telephone | 408-356-4900
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Fax | 408-356-4997
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Provider Business Mailing Address
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Address Line | 15827 LOS GATOS BLVD # B
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City | LOS GATOS
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State | CA
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Zip | 95032-3314
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Country | US
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Telephone | 408-356-4900
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Fax | 408-356-4997
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 45895
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License Number State | CA
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