Provider Demographics
NPI:1346807187
Name:KARANA, ARVIN LABIB
Entity Type:Individual
Prefix:
First Name:ARVIN
Middle Name:LABIB
Last Name:KARANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54843 NORTHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-1341
Mailing Address - Country:US
Mailing Address - Phone:586-222-8881
Mailing Address - Fax:
Practice Address - Street 1:54843 NORTHVIEW CT
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-1341
Practice Address - Country:US
Practice Address - Phone:586-222-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010231751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT100071488017OtherNON MEDICAID
MIT100071488017Medicaid