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General NPI Number Information
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NPI Number | 1356861298
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Entity Type | Individual
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Provider Name | SUSHIL PAKHRIN DMD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 4335 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-4818
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Country | US
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Telephone | 484-744-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 4335 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-4818
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Country | US
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Telephone | 484-744-6510
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS041389
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN122872
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS0000011200
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License Number State | TN
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