Provider Demographics
NPI:1053007559
Name:KYT DENTAL SERVICES
Entity type:Organization
Organization Name:KYT DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-431-6767
Mailing Address - Street 1:11180 WARNER AVE STE 251
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7515
Mailing Address - Country:US
Mailing Address - Phone:833-598-3368
Mailing Address - Fax:
Practice Address - Street 1:11180 WARNER AVE STE 251
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7515
Practice Address - Country:US
Practice Address - Phone:833-598-3368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty