Provider Demographics
NPI:1962670497
Name:BENEDA- KHOSH, DEENA KAY (ND)
Entity Type:Individual
Prefix:DR
First Name:DEENA
Middle Name:KAY
Last Name:BENEDA- KHOSH
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4935 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-3944
Mailing Address - Country:US
Mailing Address - Phone:785-749-2255
Mailing Address - Fax:785-749-7455
Practice Address - Street 1:4935 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-3944
Practice Address - Country:US
Practice Address - Phone:785-749-2255
Practice Address - Fax:785-749-7455
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21-00002175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath