Provider Demographics
NPI:1811419070
Name:KUDO CARE DENTAL PLLC
Entity type:Organization
Organization Name:KUDO CARE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANH
Authorized Official - Middle Name:QUYNH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-230-8066
Mailing Address - Street 1:3425 GRANDE BULEVAR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5108
Mailing Address - Country:US
Mailing Address - Phone:972-639-5836
Mailing Address - Fax:469-586-4761
Practice Address - Street 1:3425 GRANDE BULEVAR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5108
Practice Address - Country:US
Practice Address - Phone:972-258-8354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty