Healthcare Provider Details

I. General information

NPI: 1700702784
Provider Name (Legal Business Name): MS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 TAMIAMI TRL S
VENICE FL
34285-2420
US

IV. Provider business mailing address

273 TAMIAMI TRL S
VENICE FL
34285-2420
US

V. Phone/Fax

Practice location:
  • Phone: 941-477-1977
  • Fax: 941-477-1442
Mailing address:
  • Phone: 941-477-1977
  • Fax: 941-477-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MEENACHI SELLAPPAN
Title or Position: OWNER
Credential: DDS
Phone: 941-477-1977