Provider Demographics
NPI:1376436865
Name:KANAN, MORAD (DMD)
Entity type:Individual
Prefix:
First Name:MORAD
Middle Name:
Last Name:KANAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 RED BARN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2680
Mailing Address - Country:US
Mailing Address - Phone:469-235-5129
Mailing Address - Fax:
Practice Address - Street 1:4424 RED BARN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2680
Practice Address - Country:US
Practice Address - Phone:469-235-5129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program