MEDICARE: DR. KENNETH HO DDS

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	1223G0001X	General Practice Dentistry	50052268	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568653582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH HO DDS

Provider Business Mailing Address
First Line	:	8603 BAY PKWY FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4101
Country	:	US
Telephone Number	:	718-265-8603
Fax Number	:	718-439-3925

Provider Business Practice Location Address
First Line	:	8605 BAY PKWY FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4101
Country	:	US
Telephone Number	:	718-265-8603
Fax Number	:	718-439-3925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	04/11/2014

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