MEDICARE: KUYKENDAHL FAMILY DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1104788140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KUYKENDAHL FAMILY DENTAL

Provider Business Mailing Address
First Line	:	6002 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2542
Country	:	US
Telephone Number	:	281-783-2273
Fax Number	:	281-947-3070

Provider Business Practice Location Address
First Line	:	6002 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2542
Country	:	US
Telephone Number	:	281-783-2273
Fax Number	:

Authorized Official
Title or Position	:	DDS
Name	:	SANGHEE YUN
Credential	:
Telephone Number	:	281-825-9500

Provider Enumeration Date	:	11/28/2025
Last Update Date	:	11/28/2025

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