Minh-Phuong Isabelle Kieu

Primary specialty

DentistTaxonomy code 122300000X

License

2901021361 Issued in MI

Practice address

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Phone

(313) 494-6629

NPI assigned

Jul 7, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1003222472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAFAYETTE PLAISANCE ST APT 609",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEU",
        "first_name": "MINH-PHUONG ISABELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Kieffer
• Jillian Kielbasa
• Scott Kienzle, MA, CCC-SLP
• Thomas Charles Kies Jr., LPN
• Joseph Craig Kiesznowski, CRNA
• Kristopher Conner Kijanka, DO
• Amber Renee Kilanowski, LLPC
• Sai Srikar Kilaru
• Usha Rani Kilaru, M.D
• Darren Kilgore

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.