Khush Dentistry PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

26104 Issued in TX

Legal business name

KHUSH DENTISTRY PLLC

Doing business as

Agave Dental

Practice address

119 Business Park Drive
Suite 200
Kenedy, TX 78119

Phone

(830) 393-8333

NPI assigned

Nov 21, 2014

Last updated

Dec 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sumeet Singh Malhotra

Title

Owner

Phone

(617) 412-0792

Specialties & licenses 2

Addresses

Other names 1

• AGAVE DENTAL Doing business as

Locations

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1548667355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 10TH ST",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "781142770",
            "telephone_number": "830-393-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BUSINESS PARK DRIVE",
            "address_2": "SUITE 200",
            "city": "KENEDY",
            "state": "TX",
            "postal_code": "78119",
            "telephone_number": "830-393-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHUSH DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "SUMEET",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-412-0792"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "26104",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGAVE DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenedy Back and Neck Clinic
• Kenedy Dental PLLC
• Kenedy I Enterprises, LLC (Kenedy Health & Rehabilitation)
• Kenedy Independent School District
• Kenedy Manor Nursing Home Inc (Legacy Living Centers)
• Sara Lyn King, RPH
• Frederick Ryan Wade Krause, M.D.
• Crista Kuhn, M.S. CCC-SLP
• Charles Kwokem
• Luka Health, LLC

• General Practice Dentistry in Kenedy, TX
• Providers in Kenedy, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.