Provider Demographics
NPI:1831366269
Name:KIM D. HO DDS. PA.
Entity type:Organization
Organization Name:KIM D. HO DDS. PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-498-0288
Mailing Address - Street 1:10806 W BELLFORT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4751
Mailing Address - Country:US
Mailing Address - Phone:281-498-0288
Mailing Address - Fax:281-498-1677
Practice Address - Street 1:10806 W BELLFORT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4751
Practice Address - Country:US
Practice Address - Phone:281-498-0288
Practice Address - Fax:281-498-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1363558-01Medicaid