Provider Demographics
NPI:1396926572
Name:PARKER, KRISTI DANIELLE (DDS, MSD, RD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:DANIELLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:DDS, MSD, RD
Other - Prefix:DR
Other - First Name:KRISTI
Other - Middle Name:DANIELLE
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MSD, RD
Mailing Address - Street 1:102 HEIGHTS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3729
Mailing Address - Country:US
Mailing Address - Phone:713-993-7332
Mailing Address - Fax:
Practice Address - Street 1:102 HEIGHTS BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3729
Practice Address - Country:US
Practice Address - Phone:713-993-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321131223G0001X, 1223P0221X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered