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General NPI Number Information
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NPI Number | 1972236396
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Entity Type | Individual
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Provider Name | PRATHEEBA THIRUCENTHILVELAN DMD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 50 FLOWERS COMMERCE DR
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City | CLAYTON
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State | NC
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Zip | 27527-5491
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Country | US
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Telephone | 984-203-9501
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Fax |
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Provider Business Mailing Address
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Address Line | 13115 JOSEY LN
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City | FARMERS BRANCH
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State | TX
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Zip | 75234-6350
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14551
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License Number State | NC
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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 | 38383
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License Number State | TX
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