Provider Demographics
NPI:1467940965
Name:NAPA, KIRAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:
Last Name:NAPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 CRESTED RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-1695
Mailing Address - Country:US
Mailing Address - Phone:515-240-8250
Mailing Address - Fax:
Practice Address - Street 1:600 BOYD RD STE B
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-4860
Practice Address - Country:US
Practice Address - Phone:469-565-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10800699-89031223G0001X
UT10800699-99221223G0001X
TX35802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice