1386767895 NPI number — DR. KEVIN MARC KRANTZ D.D.S.

Table of content: DR. KEVIN MARC KRANTZ D.D.S. (NPI 1386767895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386767895 NPI number — DR. KEVIN MARC KRANTZ D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRANTZ
Provider First Name:
KEVIN
Provider Middle Name:
MARC
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386767895
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7614 BETTY JANE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77055-6808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-956-2997
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8811 FRANKWAY DR
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77096-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-666-2333
Provider Business Practice Location Address Fax Number:
713-666-2485
Provider Enumeration Date:
04/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  17672 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)