Provider Demographics
NPI:1164423984
Name:KIRAN, ASLI BANU (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASLI
Middle Name:BANU
Last Name:KIRAN
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 1:6900 WILDWOOD CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111
Mailing Address - Country:US
Mailing Address - Phone:505-856-6943
Mailing Address - Fax:505-856-6943
Practice Address - Street 1:6101 CANDELARIA NE
Practice Address - Street 2:PERFECT TEETH
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-883-0005
Practice Address - Fax:505-881-4487
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD22611223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist