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General NPI Number Information
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NPI Number | 1134992332
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Entity Type | Individual
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Provider Name | AVANTIKA KATYAL
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Gender | Female
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 305 W. 12TH AVE PERIODONTICS 2ND FLOOR, POSTLE HALL
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City | COLUMBUS
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State | OH
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Zip | 43210
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Country | US
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Telephone | 202-993-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 7253 GLEN HOLLOW CT UNIT 3
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City | ANNANDALE
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State | VA
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Zip | 22003-2560
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Country | US
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Telephone | 202-993-1025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | RES.004645
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License Number State | OH
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