Individual provider · Type 1 NPI
Shiyamali Sundararajan
Periodontics · Austin, TX
NPI number
1679254544
Active
Practice location
12319 N Mopac Expy Ste 160
Austin, TX 78758-2648
Mailing address
529 Caddo Lake Dr
Georgetown, TX 78628-7137
Other practice locations
- 529 Caddo Lake Dr, Georgetown, TX 78628-7137 · (510) 674-8439
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 39852 (TX) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
2 other providers at this address
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About NPI 1679254544
Shiyamali Sundararajan's National Provider Identifier is 1679254544, issued on Jul 25, 2023. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Austin, TX. The record was last updated on Jul 25, 2023.