Provider Demographics
NPI:1356861298
Name:PAKHRIN, SUSHIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUSHIL
Middle Name:
Last Name:PAKHRIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 KEITH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4818
Mailing Address - Country:US
Mailing Address - Phone:484-744-6510
Mailing Address - Fax:
Practice Address - Street 1:4335 KEITH ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4818
Practice Address - Country:US
Practice Address - Phone:484-744-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041389122300000X
GADN122872122300000X
TNDS0000011200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist