Provider Demographics
NPI:1154489003
Name:RAVINDRAN, SAVITHRI P (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAVITHRI
Middle Name:P
Last Name:RAVINDRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6152
Mailing Address - Country:US
Mailing Address - Phone:626-445-0678
Mailing Address - Fax:626-447-2564
Practice Address - Street 1:611 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6152
Practice Address - Country:US
Practice Address - Phone:626-445-0678
Practice Address - Fax:626-447-2564
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB31363-01Medicaid