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General NPI Number Information
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NPI Number | 1053530790
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Entity Type | Individual
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Provider Name | JEFFREY C. KIRIAN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 740 N 21ST ST
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City | NEWARK
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State | OH
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Zip | 43055-2916
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Country | US
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Telephone | 740-366-1236
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Fax | 740-348-0043
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Provider Business Mailing Address
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Address Line | 740 N 21ST ST
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City | NEWARK
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State | OH
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Zip | 43055-2916
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Country | US
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Telephone | 740-366-1236
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Fax | 740-348-0043
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30022375
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.022375
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License Number State | OH
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