Provider Demographics
NPI:1669016820
Name:DUBE, VIRGINIA KAYRON (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:KAYRON
Last Name:DUBE
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 1:2109 COUNTY ROAD 436
Mailing Address - Street 2:
Mailing Address - City:DIME BOX
Mailing Address - State:TX
Mailing Address - Zip Code:77853-5263
Mailing Address - Country:US
Mailing Address - Phone:713-823-0361
Mailing Address - Fax:
Practice Address - Street 1:11455 FALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4238
Practice Address - Country:US
Practice Address - Phone:281-890-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0129591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty