Provider Demographics
NPI:1275723389
Name:KHOO, MAUREEN ANN (DDS)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:KHOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E BROADWAY
Mailing Address - Street 2:13TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1013
Mailing Address - Country:US
Mailing Address - Phone:415-269-5203
Mailing Address - Fax:212-227-3866
Practice Address - Street 1:11 E BROADWAY
Practice Address - Street 2:FLOOR 13
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1013
Practice Address - Country:US
Practice Address - Phone:212-227-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist