Provider Demographics
NPI:1730277146
Name:KHUU, NGOC KIM (DDS)
Entity type:Individual
Prefix:
First Name:NGOC
Middle Name:KIM
Last Name:KHUU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10139 HAMMERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080
Mailing Address - Country:US
Mailing Address - Phone:713-465-0099
Mailing Address - Fax:713-465-0094
Practice Address - Street 1:10139 HAMMERLY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080
Practice Address - Country:US
Practice Address - Phone:713-465-0099
Practice Address - Fax:713-465-0094
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1779613-09Medicaid