Provider Demographics
NPI:1366002289
Name:RAMALINGAM, SAILESH (DDS)
Entity Type:Individual
Prefix:
First Name:SAILESH
Middle Name:
Last Name:RAMALINGAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 CHAPS
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5520
Mailing Address - Country:US
Mailing Address - Phone:248-619-6837
Mailing Address - Fax:
Practice Address - Street 1:9115 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-2365
Practice Address - Country:US
Practice Address - Phone:313-918-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016001791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice