Provider Demographics
NPI:1629400882
Name:KAVIANI, KEVIN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:KAVIANI
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 1:12525 MEMORIAL DR STE 280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-6050
Mailing Address - Country:US
Mailing Address - Phone:713-781-9444
Mailing Address - Fax:713-977-9257
Practice Address - Street 1:12525 MEMORIAL DR STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6050
Practice Address - Country:US
Practice Address - Phone:713-781-9444
Practice Address - Fax:713-977-9257
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist