Healthcare Provider Details

I. General information

NPI: 1801264098
Provider Name (Legal Business Name): DHANALAKSHMI SENNIAPPAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 AMENDMENT AVE
ROCK HILL SC
29732-3036
US

IV. Provider business mailing address

165 AMENDMENT AVE
ROCK HILL SC
29732-3036
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-2700
  • Fax:
Mailing address:
  • Phone: 803-329-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number84957
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: