Provider Demographics
NPI:1841630738
Name:CHERIAN, KEREN (DDS)
Entity type:Individual
Prefix:DR
First Name:KEREN
Middle Name:
Last Name:CHERIAN
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 1:950 W UNIVERSITY AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6505
Mailing Address - Country:US
Mailing Address - Phone:512-930-5930
Mailing Address - Fax:
Practice Address - Street 1:950 W UNIVERSITY AVE STE 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6505
Practice Address - Country:US
Practice Address - Phone:512-930-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist