Provider Demographics
NPI:1053726786
Name:LOPEZ- ALVAREZ, KIANI CAROLINA
Entity type:Individual
Prefix:
First Name:KIANI
Middle Name:CAROLINA
Last Name:LOPEZ- ALVAREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 TURABO CLUSTERS
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-2550
Mailing Address - Country:US
Mailing Address - Phone:787-263-2160
Mailing Address - Fax:
Practice Address - Street 1:224 TURABO CLUSTERS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-2550
Practice Address - Country:US
Practice Address - Phone:787-263-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist