Provider Demographics
NPI:1235426586
Name:KARIVALAVAN, KALAISELVI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KALAISELVI
Middle Name:
Last Name:KARIVALAVAN
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 1:1857 SAVANNAH LN
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-3678
Mailing Address - Country:US
Mailing Address - Phone:734-482-1356
Mailing Address - Fax:
Practice Address - Street 1:1857 SAVANNAH LN
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-3678
Practice Address - Country:US
Practice Address - Phone:734-482-1356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010204991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice