Provider Demographics
NPI:1578745147
Name:HARDAWAY, KORI D (DDS)
Entity type:Individual
Prefix:DR
First Name:KORI
Middle Name:D
Last Name:HARDAWAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KORI
Other - Middle Name:DANIELLE
Other - Last Name:HARDAWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4898 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1054
Mailing Address - Country:US
Mailing Address - Phone:214-821-6468
Mailing Address - Fax:
Practice Address - Street 1:4898 LITTLE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1054
Practice Address - Country:US
Practice Address - Phone:214-821-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122274122300000X
TX236731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist