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General NPI Number Information
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NPI Number | 1578948287
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Entity Type | Individual
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Provider Name | SUVENDRA VIJAYAN B.D.S, M.P.H, M.S
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Gender | Male
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 3501 TERRACE ST SALK ANNEX G119
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City | PITTSBURGH
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State | PA
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Zip | 15213-2523
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Country | US
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Telephone | 412-624-2053
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 TERRACE ST SALK ANNEX G119
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City | PITTSBURGH
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State | PA
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Zip | 15213-2523
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Country | US
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Telephone | 412-624-2053
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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 | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number | RFD000032
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number | RES-30448
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License Number State | IA
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