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NPI Code Detail

MEDICARE: AGRIMA PRADHAN DDS

MEDICARE: AGRIMA PRADHAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30.027509OH

General Provider Information

NPI Number : 1114775566
Entity Type Code : Individual
Provider Name (Legal Business Name) : AGRIMA PRADHAN DDS
Provider Business Mailing Address
First Line : 29851 SUTTON DR
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-4818
Country : US
Telephone Number : 440-370-0607
Fax Number :
Provider Business Practice Location Address
First Line : 4089 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-1614
Country : US
Telephone Number : 614-954-0700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2024
Last Update Date : 05/10/2024

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Directions to “ AGRIMA PRADHAN DDS” Practice Location

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