1962850503 NPI number — DR. HIMA BINDU DUKKA BDS, MSD

Table of content: DR. HIMA BINDU DUKKA BDS, MSD (NPI 1962850503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962850503 NPI number — DR. HIMA BINDU DUKKA BDS, MSD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUKKA
Provider First Name:
HIMA BINDU
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
BDS, MSD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUKKA
Provider Other First Name:
HIMA BINDU
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BDS, MSD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1962850503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 S PRESTON ST RM 335L
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-852-1817
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 S PRESTON ST
Provider Second Line Business Practice Location Address:
ROOM 312
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-852-1817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2016

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: 1223P0300X , with the licence number:  9707 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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