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General NPI Number Information
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NPI Number | 1285556506
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Entity Type | Individual
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Provider Name | KAVERI KRISHNAMOORTHY DDS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 550 MANHATTAN CT
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City | CANTON
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State | MI
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Zip | 48188-1492
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Country | US
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Telephone | 734-787-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 550 MANHATTAN CT
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City | CANTON
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State | MI
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Zip | 48188-1492
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Country | US
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Telephone |
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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 | 2901603271
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License Number State | MI
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