MEDICARE: VIJAYALAKSHMI NATARAJAN ANGAMUTHU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12246	MD

General Provider Information

NPI Number	:	1144211046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAYALAKSHMI NATARAJAN ANGAMUTHU DDS

Provider Business Mailing Address
First Line	:	3444 ELLICOTT CENTER DR STE 104
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4670
Country	:	US
Telephone Number	:	410-281-7700
Fax Number	:	410-281-1861

Provider Business Practice Location Address
First Line	:	3444 ELLICOTT CENTER DR STE 104
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4670
Country	:	US
Telephone Number	:	410-281-7700
Fax Number	:	410-281-1861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	04/17/2026

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