Pavithra Balasubramanian, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS040462 Issued in PA

Practice address

248 S 21St St
Philadelphia, PA 19103-5000

Phone

(215) 732-3350

NPI assigned

Jun 24, 2015

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1487036646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 W RITTENHOUSE ST",
            "address_2": "APT# 226 B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444300",
            "telephone_number": "412-874-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 S 21ST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035000",
            "telephone_number": "215-732-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASUBRAMANIAN",
        "first_name": "PAVITHRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abirami Balarajan, MD
• William Balas, R. PH.
• Marguerite Balasta, M.D.
• Easwaran Balasubramanian, MD
• Manjula Balasubramanian, MD
• Victoria Balbi, ACNPC-AG
• Daniel Balcarcel, M.D.
• Mark Balceniuk
• Laura J Balcer, MD
• Rajkumari B Balchandani, MD

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.