Provider Demographics
NPI:1134352685
Name:KAYKHA, LILY (DMD)
Entity type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:KAYKHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4455
Mailing Address - Country:US
Mailing Address - Phone:831-241-0375
Mailing Address - Fax:
Practice Address - Street 1:1001 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4455
Practice Address - Country:US
Practice Address - Phone:831-241-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist