Provider Demographics
NPI:1477125839
Name:TRIVEDI, POOJA (DDS)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:POOJA
Other - Middle Name:
Other - Last Name:KINARIWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6259 ROSEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3010
Mailing Address - Country:US
Mailing Address - Phone:248-885-9208
Mailing Address - Fax:
Practice Address - Street 1:10818 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-3649
Practice Address - Country:US
Practice Address - Phone:913-299-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62276122300000X
TX38182122300000X
PADS043278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist