Provider Demographics
NPI:1225286032
Name:SWAMI, PAVITHRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAVITHRA
Middle Name:
Last Name:SWAMI
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 1:300 N LAMAR BLVD
Mailing Address - Street 2:#335
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703
Mailing Address - Country:US
Mailing Address - Phone:510-896-9602
Mailing Address - Fax:
Practice Address - Street 1:1923 E 7TH ST
Practice Address - Street 2:SUITE#120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3419
Practice Address - Country:US
Practice Address - Phone:512-236-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice