Provider Demographics
NPI:1861183998
Name:SERRANO, KIMBERLY JEANETTE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JEANETTE
Last Name:SERRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2760
Mailing Address - Country:US
Mailing Address - Phone:281-730-7711
Mailing Address - Fax:
Practice Address - Street 1:3124 S HIGHWAY 35 # 1040
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-1404
Practice Address - Country:US
Practice Address - Phone:281-585-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist