Provider Demographics
NPI:1497885693
Name:KANI, SUNDY (OD)
Entity Type:Individual
Prefix:MRS
First Name:SUNDY
Middle Name:
Last Name:KANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 RAVENHILL CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4955
Mailing Address - Country:US
Mailing Address - Phone:303-683-3372
Mailing Address - Fax:
Practice Address - Street 1:4810 CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5152
Practice Address - Country:US
Practice Address - Phone:303-576-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1772152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist