Provider Demographics
NPI:1124243597
Name:KIRBY, CINDY (DDS)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:KIRBY
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 1:1000 E 80TH PLACE SUITE 523 SOUTH
Mailing Address - Street 2:
Mailing Address - City:MERRILLIVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-769-4246
Mailing Address - Fax:219-769-4273
Practice Address - Street 1:1000 E 80TH PL STE 523
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE BRA
Practice Address - State:IN
Practice Address - Zip Code:46410-5608
Practice Address - Country:US
Practice Address - Phone:219-769-4246
Practice Address - Fax:219-769-4273
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008590B1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice