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General NPI Number Information
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NPI Number | 1538473756
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Entity Type | Individual
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Provider Name | KIRAN M YANALA DMD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 2110 W SLAUGHTER LN STE 190
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City | AUSTIN
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State | TX
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Zip | 78748-5997
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Country | US
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Telephone | 512-593-4465
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 W CAMINO DEL ARCO
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City | HOBBS
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State | NM
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Zip | 88240-0979
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Country | US
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Telephone | 973-220-4615
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DD3587
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License Number State | NM
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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 | 26283
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License Number State | TX
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