Provider Demographics
NPI:1295846269
Name:VARKEY, GEORGE PLATHOTTAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PLATHOTTAM
Last Name:VARKEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:VARKEY
Other - Last Name:PLATHOTTAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:723 SOUTHPARK BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3628
Mailing Address - Country:US
Mailing Address - Phone:804-270-9989
Mailing Address - Fax:804-270-9296
Practice Address - Street 1:723 SOUTHPARK BLVD STE F
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3628
Practice Address - Country:US
Practice Address - Phone:804-270-9989
Practice Address - Fax:804-270-9296
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-01-12
Deactivation Date:2020-12-11
Deactivation Code:
Reactivation Date:2021-01-07
Provider Licenses
StateLicense IDTaxonomies
VA0401411075122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9179218Medicaid