Sudarvizhi Sivaraman, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022465 Issued in MI

Practice address

21219 Mack Ave
Grosse Pointe Woods, MI 48236-1045

Phone

(313) 882-7961

NPI assigned

Aug 4, 2017

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Dr. Siv'S Dentistry PLLC

  • Dental Clinic/Center
  • Grosse Pointe Woods, MI
  • NPI 1457102980
  NPD
• Dental Dreams PLLC

  • General Practice Dentistry
  • Eastpointe, MI
  • NPI 1407263163
  NPD (past)
• Kusch & Raubolt PLLC

  • General Practice Dentistry
  • Grosse Pointe Woods, MI
  • NPI 1689743395
  NPD (past)

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1972028488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21219 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361045",
            "telephone_number": "313-882-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21219 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361045",
            "telephone_number": "313-882-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVARAMAN",
        "first_name": "SUDARVIZHI",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad S Shurafa, M.D.
• Trista Marie Shuttleworth
• Monica Saldana Silva
• Kathleen Anne Sime, MS, ATC
• Ashley Nicole Simons
• Ojhair Sledge-Cleveland
• Alexis Smith
• Victoria Olivia Smith
• Yasmyne Dmya Smith
• Jenna Snapp

• General Practice Dentistry in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.