Provider Demographics
NPI:1336252139
Name:RANJBAR, N. DANIEL (DDS, PA)
Entity type:Individual
Prefix:
First Name:N.
Middle Name:DANIEL
Last Name:RANJBAR
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 QUAIL CREST PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3838
Mailing Address - Country:US
Mailing Address - Phone:785-832-1844
Mailing Address - Fax:785-832-8734
Practice Address - Street 1:4828 QUAIL CREST PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3838
Practice Address - Country:US
Practice Address - Phone:785-832-1844
Practice Address - Fax:785-832-8734
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS68311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics