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General NPI Number Information
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NPI Number | 1154981561
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Entity Type | Individual
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Provider Name | MADHUMIETHA ARUMUGAM DMD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1134 E MAIN ST
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City | STAMFORD
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State | CT
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Zip | 06902-4315
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Country | US
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Telephone | 203-973-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 53 COGNEWAUGH RD
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City | COS COB
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State | CT
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Zip | 06807-1710
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Country | US
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Telephone | 201-850-7896
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS042181
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02760200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2.012553
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License Number State | CT
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