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General NPI Number Information
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NPI Number | 1588644280
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Entity Type | Individual
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Provider Name | DIWAKAR KINRA DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5409 GATEWAY CTR STE F
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City | FLINT
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State | MI
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Zip | 48507-3992
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Country | US
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Telephone | 810-235-0100
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Fax | 810-235-0100
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Provider Business Mailing Address
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Address Line | 750 REGISTRY LN
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City | ATLANTA
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State | GA
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Zip | 30342-2865
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Country | US
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Telephone |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 015485
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 017716
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License Number State | MI
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