Provider Demographics
NPI:1326365834
Name:THIEN KHAN, P.A.
Entity Type:Organization
Organization Name:THIEN KHAN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CUONG
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-473-9300
Mailing Address - Street 1:2100 DALLAS PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4363
Mailing Address - Country:US
Mailing Address - Phone:972-473-9300
Mailing Address - Fax:972-473-9334
Practice Address - Street 1:2100 DALLAS PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4363
Practice Address - Country:US
Practice Address - Phone:972-473-9300
Practice Address - Fax:972-473-9334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty