Healthcare Provider Details

I. General information

NPI: 1841873510
Provider Name (Legal Business Name): MITHUN DHINAKARAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VCUHS DEPARTMENT OF PSYCHIATRY RESIDENCY, 980710 1250 E. MARSHALL STREET
RICHMOND VA
23298-0710
US

IV. Provider business mailing address

830 MAGNOLIA ST
DENVER CO
80220-4716
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-7912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0075283
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: