NPI 1871500611 · live from the CMS NPI Registry
Vijayalakshmi Canakalavenkata, DMD
Dentist, General Practice in Providence, RI. National Provider Identifier 1871500611, active.
NPI record
| NPI | 1871500611 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 66 Kennedy Plz, Providence, RI 02903 |
| Practice phone | 401-454-3000 |
| Mailing address | 860 Harrison Ave, Apt 1012, Boston, MA 02118 |
| Enumerated | August 2, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | DEN02932 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.