Provider Demographics
NPI:1962795609
Name:KOZINN, KINNERET (DDS)
Entity type:Individual
Prefix:DR
First Name:KINNERET
Middle Name:
Last Name:KOZINN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KINNERET
Other - Middle Name:
Other - Last Name:ALBALAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6500 MCNEIL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7720
Mailing Address - Country:US
Mailing Address - Phone:512-331-1477
Mailing Address - Fax:
Practice Address - Street 1:6500 MCNEIL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7720
Practice Address - Country:US
Practice Address - Phone:512-331-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26487122300000X
OH30.024014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist