Provider Demographics
NPI:1154414415
Name:PRAJAPATI, KINNARI M (DDS)
Entity type:Individual
Prefix:DR
First Name:KINNARI
Middle Name:M
Last Name:PRAJAPATI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1618 CANYON CREEK DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3275
Mailing Address - Country:US
Mailing Address - Phone:254-771-5900
Mailing Address - Fax:254-771-5380
Practice Address - Street 1:1618 CANYON CREEK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3275
Practice Address - Country:US
Practice Address - Phone:254-771-5900
Practice Address - Fax:254-771-5380
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX206171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD20617OtherBLUE CROSS BLUE SHIELD
TX01361994OtherUNITED CONCORDIA
TXB20617OtherCHIPS