Provider Demographics
NPI:1083138440
Name:PADINJARAL KRISHNA, INDHYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:INDHYA
Middle Name:
Last Name:PADINJARAL KRISHNA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:INDHYA
Other - Middle Name:
Other - Last Name:PADINJARAL SASIDHARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:405 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4211
Mailing Address - Country:US
Mailing Address - Phone:971-300-3291
Mailing Address - Fax:
Practice Address - Street 1:405 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4211
Practice Address - Country:US
Practice Address - Phone:971-300-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10704122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist