Provider Demographics
NPI:1992212310
Name:K-TECH DENTAL GROUP, PC
Entity Type:Organization
Organization Name:K-TECH DENTAL GROUP, PC
Other - Org Name:KOH & ASSOCIATES, DDS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:I
Authorized Official - Last Name:KOH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:703-815-0699
Mailing Address - Street 1:14016 SULLYFIELD CIR STE B
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-4010
Mailing Address - Country:US
Mailing Address - Phone:703-815-0699
Mailing Address - Fax:
Practice Address - Street 1:14016 SULLYFIELD CIR STE B
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-4010
Practice Address - Country:US
Practice Address - Phone:703-815-0699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411961261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental