Provider Demographics
NPI:1659738367
Name:CARRAZANA, KRITIKA JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRITIKA
Middle Name:JO
Last Name:CARRAZANA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 COPPER PEAK DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4901
Mailing Address - Country:US
Mailing Address - Phone:772-563-3540
Mailing Address - Fax:
Practice Address - Street 1:675 PINE AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-3373
Practice Address - Country:US
Practice Address - Phone:831-649-1055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025523122300000X
KS611371223P0221X
MO20160148661223P0221X
CA1074511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist