Provider Demographics
NPI:1689430639
Name:DKC DMD PLLC
Entity Type:Organization
Organization Name:DKC DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANYALLE
Authorized Official - Middle Name:KAHAEHOLOOKALANI
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-220-8726
Mailing Address - Street 1:3225 S RAINBOW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6229
Mailing Address - Country:US
Mailing Address - Phone:702-220-8726
Mailing Address - Fax:702-755-3771
Practice Address - Street 1:3225 S RAINBOW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6229
Practice Address - Country:US
Practice Address - Phone:702-220-8726
Practice Address - Fax:702-755-3771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DKC DMD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-27
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental