Provider Demographics
NPI:1528211174
Name:LENOX DENTAL
Entity Type:Organization
Organization Name:LENOX DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NGUYET
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:KHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-772-0106
Mailing Address - Street 1:10 S KYRENE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4524
Mailing Address - Country:US
Mailing Address - Phone:480-292-7725
Mailing Address - Fax:
Practice Address - Street 1:10 S KYRENE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4524
Practice Address - Country:US
Practice Address - Phone:480-292-7725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ75721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty