Provider Demographics
NPI:1346305729
Name:KHEMANI, KIRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:
Last Name:KHEMANI
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 1:20406 REDWOOD RD STE C-1
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4317
Mailing Address - Country:US
Mailing Address - Phone:510-582-7919
Mailing Address - Fax:510-582-8745
Practice Address - Street 1:20406 REDWOOD RD
Practice Address - Street 2:SUITE C-1
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4317
Practice Address - Country:US
Practice Address - Phone:408-582-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482971223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist