Provider Demographics
NPI:1114191384
Name:GREEP, TARAN KIRKHAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:TARAN
Middle Name:KIRKHAM
Last Name:GREEP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 W CAMELBACK RD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-1355
Mailing Address - Country:US
Mailing Address - Phone:623-848-8500
Mailing Address - Fax:623-848-8557
Practice Address - Street 1:9515 W CAMELBACK RD
Practice Address - Street 2:SUITE 128
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-1355
Practice Address - Country:US
Practice Address - Phone:623-848-8500
Practice Address - Fax:623-848-8557
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice