MEDICARE: PERRAYCHUDHAN SARAVANANE

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	122300000X	Dentist	0401419562	VA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1245918655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERRAYCHUDHAN SARAVANANE

Provider Business Mailing Address
First Line	:	7089 MECHANICSVILLE TPKE STE A
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-3609
Country	:	US
Telephone Number	:	804-417-7788
Fax Number	:

Provider Business Practice Location Address
First Line	:	7089 MECHANICSVILLE TPKE STE A
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-3609
Country	:	US
Telephone Number	:	804-417-7788
Fax Number	:

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

Provider Enumeration Date	:	07/06/2023
Last Update Date	:	07/20/2025

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