1609885938 NPI number — KRISHNA & V.R., P.C.

Table of content: (NPI 1609885938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609885938 NPI number — KRISHNA & V.R., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRISHNA & V.R., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1609885938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8929 S MEMORIAL DR
Provider Second Line Business Mailing Address:
SUITE # 290
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74133-4330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-254-0135
Provider Business Mailing Address Fax Number:
918-254-5116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8929 S MEMORIAL DR
Provider Second Line Business Practice Location Address:
SUITE # 290
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74133-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-254-0135
Provider Business Practice Location Address Fax Number:
918-254-5116
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SUTHAR
Authorized Official First Name:
PRAGNA
Authorized Official Middle Name:
HEMANT
Authorized Official Title or Position:
DENTIST/ OWNER
Authorized Official Telephone Number:
918-254-0135

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  5341 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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