Provider Demographics
NPI:1861586646
Name:KAU, KIMBERLY (DDS)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:KAU
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 1:3925 OLD SANTA RITA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-9478
Mailing Address - Country:US
Mailing Address - Phone:925-924-1740
Mailing Address - Fax:925-924-1739
Practice Address - Street 1:3925 OLD SANTA RITA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-9478
Practice Address - Country:US
Practice Address - Phone:925-924-1740
Practice Address - Fax:925-924-1739
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice