1477125839 NPI number — POOJA TRIVEDI DDS

Table of content: POOJA TRIVEDI DDS (NPI 1477125839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477125839 NPI number — POOJA TRIVEDI DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRIVEDI
Provider First Name:
POOJA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KINARIWALA
Provider Other First Name:
POOJA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477125839
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6259 ROSEWOOD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66205-3010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-885-9208
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10818 PARALLEL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66109-3649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-299-8860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2021

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: 122300000X , with the licence number:  62276 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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