Healthcare Provider Details

I. General information

NPI: 1841127354
Provider Name (Legal Business Name): KARTHIK SASTRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 WYOMING ST STE 100W
DAYTON OH
45409-2741
US

IV. Provider business mailing address

161 WYOMING STREET, SUITE 100W, DAYTON, OH., 45409
DAYTON OH
45409
US

V. Phone/Fax

Practice location:
  • Phone: 937-279-8600
  • Fax:
Mailing address:
  • Phone: 937-279-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.260511
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: