Provider Demographics
NPI:1568196913
Name:DINH, KELLY HAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:HAN
Last Name:DINH
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 1:519 CRESTWATER CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1517
Mailing Address - Country:US
Mailing Address - Phone:281-716-2152
Mailing Address - Fax:
Practice Address - Street 1:24441 KATY FWY STE 200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1429
Practice Address - Country:US
Practice Address - Phone:281-394-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice