Provider Demographics
NPI:1326107558
Name:TO, KENNETH HANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:HANG
Last Name:TO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10128 HAMMERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-5010
Mailing Address - Country:US
Mailing Address - Phone:713-464-4774
Mailing Address - Fax:713-464-6776
Practice Address - Street 1:10128 HAMMERLY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-5010
Practice Address - Country:US
Practice Address - Phone:713-464-4774
Practice Address - Fax:713-464-6776
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19141122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130704301Medicaid