MEDICARE: SALIYA SENEVIRATNE 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	DS040690	PA

General Provider Information

NPI Number	:	1801257282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALIYA SENEVIRATNE DMD

Provider Business Mailing Address
First Line	:	3 W MCKINLEY WAY
Second Line	:
City	:	POLAND
State	:	OH
Zip	:	44514-3904
Country	:	US
Telephone Number	:	330-707-9808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 FREEDOM RD
Second Line	:
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-5016
Country	:	US
Telephone Number	:	724-772-2788
Fax Number	:

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

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	10/31/2016

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