MEDICARE: DR. PALLAVI SINHA DMD

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
1	122300000X	Dentist	2004025287	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386783751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PALLAVI SINHA DMD

Provider Business Mailing Address
First Line	:	12486 TESSON FERRY RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-2702
Country	:	US
Telephone Number	:	314-843-5533
Fax Number	:	314-843-4801

Provider Business Practice Location Address
First Line	:	12486 TESSON FERRY RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-2702
Country	:	US
Telephone Number	:	314-843-5533
Fax Number	:	314-843-4801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/11/2014

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