Provider Demographics
NPI:1285750109
Name:SATASHIA, KIRAN (DMD)
Entity type:Individual
Prefix:
First Name:KIRAN
Middle Name:
Last Name:SATASHIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BREEZY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3587
Mailing Address - Country:US
Mailing Address - Phone:215-997-8055
Mailing Address - Fax:215-957-0703
Practice Address - Street 1:1590 W STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3130
Practice Address - Country:US
Practice Address - Phone:215-957-0700
Practice Address - Fax:215-957-0703
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-035009-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA74672OtherDHA-ASSURANT
PA7916508OtherATENA
PA1399.913OtherUNITED CONCORDIA