Provider Demographics
NPI:1568522100
Name:DIRANI, GEORGE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:DIRANI
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 1:2259 CLAYETTE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3725
Mailing Address - Country:US
Mailing Address - Phone:919-528-9500
Mailing Address - Fax:919-528-9556
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:SUITE 106
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:919-528-9500
Practice Address - Fax:919-528-9556
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7870OtherDENTAL LICENSE