Provider Demographics
NPI:1912631474
Name:CARRAZANA, DDS, APDC
Entity Type:Organization
Organization Name:CARRAZANA, DDS, APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRITIKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARRAZANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-649-1055
Mailing Address - Street 1:3123 COPPER PEAK DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4901
Mailing Address - Country:US
Mailing Address - Phone:772-563-3540
Mailing Address - Fax:
Practice Address - Street 1:675 PINE AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-3373
Practice Address - Country:US
Practice Address - Phone:831-649-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty