Provider Demographics
NPI:1316160575
Name:KO, KEVIN KINGHANG (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:KINGHANG
Last Name:KO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 OLD TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4185
Mailing Address - Country:US
Mailing Address - Phone:925-934-0192
Mailing Address - Fax:925-448-3833
Practice Address - Street 1:3190 OLD TUNNEL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4185
Practice Address - Country:US
Practice Address - Phone:925-934-0192
Practice Address - Fax:925-448-3833
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice