Provider Demographics
NPI:1407742372
Name:KELLEY JOO PLLC DDS
Entity type:Organization
Organization Name:KELLEY JOO PLLC DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:SOHYE
Authorized Official - Last Name:JOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-920-3195
Mailing Address - Street 1:2000 TAYLOR ST APT 301
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-4559
Mailing Address - Country:US
Mailing Address - Phone:832-920-3195
Mailing Address - Fax:
Practice Address - Street 1:9506 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4901
Practice Address - Country:US
Practice Address - Phone:832-920-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental