Provider Demographics
NPI:1952457913
Name:LARKIN, KELLY NOELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:NOELLE
Last Name:LARKIN
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 1:1201 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2233
Mailing Address - Country:US
Mailing Address - Phone:559-685-4622
Mailing Address - Fax:559-686-2375
Practice Address - Street 1:1008 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2212
Practice Address - Country:US
Practice Address - Phone:559-684-4355
Practice Address - Fax:559-684-4357
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice