Healthcare Provider Details

I. General information

NPI: 1447545553
Provider Name (Legal Business Name): SUVIKA KAPUR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUVIKA KAPUR VIRMANI DMD

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MAIN ST
HARTFORD CT
06106-1860
US

IV. Provider business mailing address

205 VERNON AVE #227
VERNON CT
06066-4348
US

V. Phone/Fax

Practice location:
  • Phone: 860-899-2804
  • Fax: 860-899-2803
Mailing address:
  • Phone: 706-631-2740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number010553
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: