Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MANUEL LUIS IRAVEDRA, D.M.D., B.S.PH
Active Sole ProprietorDR. MANUEL LUIS IRAVEDRA, D.M.D., B.S.PH is a Periodontology healthcare provider located in CHINLE, Arizona. NPI 1801941422 is currently active in the NPPES registry. Verify at CMS.
Periodontology · CHINLE, AZ
Registration Details
- NPI Number
- 1801941422
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 24, 2007 (19.532939908581 yrs)
- Last Updated
- Dec 9, 2019
- Licenses
-
2750 (PR)D1388 (PR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
PO BOX PHCHINLE, AZ, 865038000Browse AZ providers · Browse ZIP 86503
- Phone
- 9286747001
- Primary Specialty
-
Periodontology
1223P0300X
- Additional Specialty
- Periodontology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.