Provider Demographics
NPI:1689883118
Name:KONG, SARAH HESHIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:HESHIN
Last Name:KONG
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 1:8222 DOUGLAS AVE
Mailing Address - Street 2:SUITE 509
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5923
Mailing Address - Country:US
Mailing Address - Phone:214-396-7876
Mailing Address - Fax:
Practice Address - Street 1:8222 DOUGLAS AVE
Practice Address - Street 2:SUITE 509
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5923
Practice Address - Country:US
Practice Address - Phone:214-396-7876
Practice Address - Fax:469-453-3205
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice