Provider Demographics
NPI:1518309657
Name:QI, KE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KE
Middle Name:
Last Name:QI
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 1:116 JACK WHITE DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664
Mailing Address - Country:US
Mailing Address - Phone:423-247-6961
Mailing Address - Fax:423-247-5552
Practice Address - Street 1:116 JACK WHITE DR
Practice Address - Street 2:SUITE 12
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-2380
Practice Address - Country:US
Practice Address - Phone:423-247-6961
Practice Address - Fax:423-247-5552
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9696122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist