Individual provider Active NPI

Kevin V Hua, DDS

  • Dentist
  • Richardson, TX
National Provider Identifier
1174021760
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33190 Issued in TX
Practice address
4251 E. Renner Rd-
#126
Richardson, TX 75082
Phone
(972) 231-6300
Fax
(972) 231-6150
NPI assigned
Jan 29, 2018
Last updated
Jan 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 33190 TX Primary

Addresses

Primary practice location

4251 E. Renner Rd-
#126
Richardson, TX 75082

Mailing address

4251 E. Renner Rd-
#126
Richardson, TX 75082
Phone (972) 231-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180404002076 TX Order and Referring Only - DentistPractitioner - Dentist 7618230657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33190TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DFW FTBC 1 LLC PastSince Jan 16, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1174021760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 E. RENNER RD-",
            "address_2": "#126",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "972-231-6300",
            "fax_number": "972-231-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 E. RENNER RD-",
            "address_2": "#126",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "972-231-6300",
            "fax_number": "972-231-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUA",
        "first_name": "KEVIN",
        "middle_name": "V",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.