Archana Nallasivam, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.027229 Issued in OH

Practice address

4122 Hunt Rd
Blue Ash, OH 45236-1159

Phone

(513) 828-6708

NPI assigned

Jun 19, 2023

Last updated

Jun 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nguyen Blue Ash Modern Dentistry PC, Inc.

  • General Practice Dentistry
  • Blue Ash, OH
  • NPI 1619625134
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1457036410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 HUNT RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452361159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 HUNT RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452361159",
            "telephone_number": "513-828-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLASIVAM",
        "first_name": "ARCHANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Muskopf
• Adam Barrs Mussman, M.D.
• Lashonda Mustafa
• Katelyn S Myers, LPCC
• Theresa Marie Nagy, LPCC
• Kassandra Nance, QMHS
• Nancy Stella PHD PSYD, LLC
• Emily Claire Naylor, O.D.
• ND Health Associates
• Rebecca Avery Neal, LISW

• Dentist in Blue Ash, OH
• Providers in Blue Ash, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.