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General NPI Number Information
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NPI Number | 1366134744
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Entity Type | Individual
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Provider Name | SELVI MAHALAKSHMI DAS PURKAYASTHA DMD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 3439 MCGEHEE RD STE 22B
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City | MONTGOMERY
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State | AL
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Zip | 36111-3392
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Country | US
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Telephone | 334-284-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 25 W 132ND ST APT 2U
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City | NEW YORK
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State | NY
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Zip | 10037-3218
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Country | US
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Telephone | 630-664-9513
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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 | D.007310-C1
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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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 | D.007310-C1
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License Number State | AL
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