Provider Demographics
NPI:1669734356
Name:HUYNH, KATI N (DMD)
Entity type:Individual
Prefix:
First Name:KATI
Middle Name:N
Last Name:HUYNH
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 1:14215 COIT RD STE 112
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2852
Mailing Address - Country:US
Mailing Address - Phone:972-701-8282
Mailing Address - Fax:972-801-8284
Practice Address - Street 1:14215 COIT RD STE 112
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-2852
Practice Address - Country:US
Practice Address - Phone:972-701-8282
Practice Address - Fax:972-801-8284
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-09
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28721122300000X
AZD0084451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist