| Kenpan Hu Dmd Pa | |
|
2426 S Carrier Pkwy Suite 100 Grand Prairie TX 75051-3805 | |
| (972) 641-2994 | |
| Not Available |
| Full Name | Kenpan Hu Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 2426 S Carrier Pkwy, Grand Prairie, Texas |
| Authorized Official Name and Position | Kenpan Hu (PRESIDENT) |
| Authorized Official Contact | 6173197110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenpan Hu Dmd Pa 2426 S Carrier Pkwy Suite 100 Grand Prairie TX 75051-3805 Ph: () - | Kenpan Hu Dmd Pa 2426 S Carrier Pkwy Suite 100 Grand Prairie TX 75051-3805 Ph: (972) 641-2994 |
| NPI Number | 1396118337 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 11/12/2015 |
| Medicare PECOS PAC ID | 1658769534 |
|---|---|
| Medicare Enrollment ID | O20211026001351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396118337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 27439 (Texas) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 25977 (Texas) | Secondary |
| Provider Name | Kenpan Hu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1417182924 PECOS PAC ID: 5092123661 Enrollment ID: I20210420001392 |
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