Basic Information
Provider Information | |||||||||
NPI: | 1548486996 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SAWHNEY | ||||||||
FirstName: | RAVI | ||||||||
MiddleName: | KUMAR | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | DDS, MSD, PHD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 16 ARCADE UNIT 198747 | ||||||||
Address2: |   | ||||||||
City: | NASHVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 372191994 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6157500343 | ||||||||
FaxNumber: | 6159861705 | ||||||||
Practice Location | |||||||||
Address1: | 3401 GEORGIA AVE NW | ||||||||
Address2: | SMALL SMILES DENTAL CENTERS OF WASHINGTON, DC | ||||||||
City: | WASHINGTON | ||||||||
State: | DC | ||||||||
PostalCode: | 200102501 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2028295437 | ||||||||
FaxNumber: | 2028299255 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/17/2007 | ||||||||
LastUpdateDate: | 02/03/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 6465 | NC | N |   | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics | 1223X0400X | DEN1001276 | DC | Y |   | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.