Provider Demographics
NPI:1831279108
Name:KAPADIA, KIRAN (DDS)
Entity type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:KAPADIA
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 1:2002 E SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3143
Mailing Address - Country:US
Mailing Address - Phone:517-482-0885
Mailing Address - Fax:517-482-7445
Practice Address - Street 1:2002 E SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3143
Practice Address - Country:US
Practice Address - Phone:517-482-0885
Practice Address - Fax:517-482-7445
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4886929Medicaid