Healthcare Provider Details

I. General information

NPI: 1548318652
Provider Name (Legal Business Name): PURNIMA KUMAR DDS, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109-1078
US

IV. Provider business mailing address

2540 ABINGTON RD
UPPER ARLINGTON OH
43221-3004
US

V. Phone/Fax

Practice location:
  • Phone: 734-763-3325
  • Fax:
Mailing address:
  • Phone: 614-292-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number71-000197
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901601270
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: