1770021172 NPI number — DR. KARTHIKEYAN SUBRAMANI B.D.S., M.SC., M.S

Table of content: (NPI 1386817146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770021172 NPI number — DR. KARTHIKEYAN SUBRAMANI B.D.S., M.SC., M.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUBRAMANI
Provider First Name:
KARTHIKEYAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
B.D.S., M.SC., M.S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770021172
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1072 VIA DELLA COSTRELLA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89011-0955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-797-1633
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 SUNSET WAY STE C
Provider Second Line Business Practice Location Address:
ROSEMAN UNIVERSITY OF HEALTH SCIENCES
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89014-2016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-968-7054
Provider Business Practice Location Address Fax Number:
702-968-5277
Provider Enumeration Date:
02/06/2017

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: 1223X0400X , with the licence number:  LL-439-16 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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