Healthcare Provider Details

I. General information

NPI: 1316089857
Provider Name (Legal Business Name): VIVEK HIRANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. VICK HIRANI

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13915 N DYSART RD STE A1 LITTLE SMILES OF SURPRISE
EL MIRAGE AZ
85335-7333
US

IV. Provider business mailing address

7090 W ANDREW LN
PEORIA AZ
85383-3040
US

V. Phone/Fax

Practice location:
  • Phone: 623-444-6340
  • Fax: 623-444-6350
Mailing address:
  • Phone: 623-551-8379
  • Fax: 623-551-8379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD6255
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: