# KIM HENDERSON KIDS DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HENDERSON KIDS DENTISTRY AND ORTHODONTICS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568153161
- **Authorized official:** KYUNG M KING DDS (OWNER)
- **Authorized official phone:** (702) 558-8543

## Contact information

- **Practice address:** 382 W LAKE MEAD PKWY STE 130, HENDERSON, NV 89015-7292
- **Practice address phone:** (703) 558-8543
- **Practice address fax:** (702) 673-1119
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2023
- **Last updated:** 05/16/2023