Provider Demographics
NPI:1942965504
Name:DANKHA, KIM (DOCTOR OF OPTOMETRY)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:DANKHA
Suffix:
Gender:F
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:KORKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOCTOR OF OPTOMETRY
Mailing Address - Street 1:19417 N 37TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3913
Mailing Address - Country:US
Mailing Address - Phone:708-417-9055
Mailing Address - Fax:
Practice Address - Street 1:19408 N 36TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3907
Practice Address - Country:US
Practice Address - Phone:708-417-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002547152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist