Provider Demographics
NPI:1083844328
Name:KOGANTI KAZA, RANI SAMYUKTHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANI
Middle Name:SAMYUKTHA
Last Name:KOGANTI KAZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21699 E QUINCY AVE UNIT H
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2886
Mailing Address - Country:US
Mailing Address - Phone:720-222-3132
Mailing Address - Fax:720-330-9919
Practice Address - Street 1:21699 E QUINCY AVE UNIT H
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2886
Practice Address - Country:US
Practice Address - Phone:720-222-3132
Practice Address - Fax:720-330-9919
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014125791223G0001X
CO002031331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice