Provider Demographics
NPI:1164518627
Name:IGANIAN, KRIS K (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:K
Last Name:IGANIAN
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 1:1530 FINDLAY WAY
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6922
Mailing Address - Country:US
Mailing Address - Phone:480-363-1009
Mailing Address - Fax:
Practice Address - Street 1:877 E SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1345
Practice Address - Country:US
Practice Address - Phone:720-476-5504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist