Provider Demographics
NPI:1518111541
Name:KAHLON, JASMINE (DDS)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:KAHLON
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 1:10216 SE 256TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6437
Mailing Address - Country:US
Mailing Address - Phone:253-856-3384
Mailing Address - Fax:
Practice Address - Street 1:10216 SE 256TH ST STE 108
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6437
Practice Address - Country:US
Practice Address - Phone:253-856-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600342371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice