Provider Demographics
NPI:1427555994
Name:GUNARAJASINGAM, AYINKERAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:AYINKERAN
Middle Name:
Last Name:GUNARAJASINGAM
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 1:17016 E INDIANA PKWY APT K207
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-5321
Mailing Address - Country:US
Mailing Address - Phone:617-922-7219
Mailing Address - Fax:
Practice Address - Street 1:4001 N COOK ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5879
Practice Address - Country:US
Practice Address - Phone:509-483-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60865941122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE60865941OtherDENTAL LICENSE