Provider Demographics
NPI:1851859391
Name:KUEI GHORBANIAN PLLC
Entity Type:Organization
Organization Name:KUEI GHORBANIAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:KUEI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-618-1028
Mailing Address - Street 1:1648 PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4325
Mailing Address - Country:US
Mailing Address - Phone:509-522-2220
Mailing Address - Fax:
Practice Address - Street 1:1648 PLAZA WAY
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4325
Practice Address - Country:US
Practice Address - Phone:509-522-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty