Provider Demographics
NPI:1891933875
Name:CHOW, EDMOND KENNETH (DDS)
Entity Type:Individual
Prefix:MR
First Name:EDMOND
Middle Name:KENNETH
Last Name:CHOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10818 ROSIN JAW STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4507
Mailing Address - Country:US
Mailing Address - Phone:916-804-8989
Mailing Address - Fax:
Practice Address - Street 1:10818 ROSIN JAW ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-4507
Practice Address - Country:US
Practice Address - Phone:916-804-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0356941223E0200X
NVS7-117C1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty