Healthcare Provider Details

I. General information

NPI: 1639724438
Provider Name (Legal Business Name): VINAYAK JOSHI BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 FLORIDA AVE
NEW ORLEANS LA
70119-2715
US

IV. Provider business mailing address

1100 FLORIDA AVE
NEW ORLEANS LA
70119-2715
US

V. Phone/Fax

Practice location:
  • Phone: 614-674-7388
  • Fax: 614-292-4612
Mailing address:
  • Phone: 614-674-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberP-198
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberP-198
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: