Provider Demographics
NPI:1619244944
Name:KIEU, HANH T (DENTAL HYGENTIST)
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:T
Last Name:KIEU
Suffix:
Gender:F
Credentials:DENTAL HYGENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4436
Mailing Address - Country:US
Mailing Address - Phone:316-269-0677
Mailing Address - Fax:316-262-0318
Practice Address - Street 1:2318 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4436
Practice Address - Country:US
Practice Address - Phone:316-269-0677
Practice Address - Fax:316-262-0318
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10232124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist