Provider Demographics
NPI:1255478954
Name:KENNETH A. LEPOW, DDS, INC.
Entity Type:Organization
Organization Name:KENNETH A. LEPOW, DDS, INC.
Other - Org Name:LEPOW DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEPOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:713-937-0050
Mailing Address - Street 1:9125 WEST RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-8623
Mailing Address - Country:US
Mailing Address - Phone:713-937-0050
Mailing Address - Fax:832-467-3960
Practice Address - Street 1:9125 WEST RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-8623
Practice Address - Country:US
Practice Address - Phone:713-937-0050
Practice Address - Fax:832-467-3960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225501223E0200X
TX264641223E0200X
TX274221223E0200X
TX111031223G0001X
TX198431223G0001X
TX228531223G0001X
TX240321223P0221X
TX195031223P0300X
TX183951223P0700X
TX188511223P0700X
TX226051223S0112X
TX200291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty