Provider Demographics
NPI:1285490466
Name:KHAU, KAYLA TRINH (RDH)
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:TRINH
Last Name:KHAU
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4340
Mailing Address - Country:US
Mailing Address - Phone:757-753-0079
Mailing Address - Fax:
Practice Address - Street 1:12 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4340
Practice Address - Country:US
Practice Address - Phone:757-753-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402208407124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist