Provider Demographics
NPI:1508495466
Name:PARKWAY FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:PARKWAY FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM CHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-319-5256
Mailing Address - Street 1:49 FAIRWAY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3339
Mailing Address - Country:US
Mailing Address - Phone:504-319-5256
Mailing Address - Fax:
Practice Address - Street 1:441 TERRY PKWY STE B
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-2780
Practice Address - Country:US
Practice Address - Phone:504-319-5256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental