1528722477 NPI number — DR. YAMUNA DEVI SUBRAMANIAN DMD

Table of content: DR. YAMUNA DEVI SUBRAMANIAN DMD (NPI 1528722477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528722477 NPI number — DR. YAMUNA DEVI SUBRAMANIAN DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUBRAMANIAN
Provider First Name:
YAMUNA DEVI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUBRAMANIAN
Provider Other First Name:
YAMUNA DEVI
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528722477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 POLLEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA PLATA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20646-3211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-797-2710
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46519 LEESBURG PIKE STE 145
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20164-3577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-496-0095
Provider Business Practice Location Address Fax Number:
346-509-6074
Provider Enumeration Date:
10/27/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  0401417648 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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