Provider Demographics
NPI:1467645796
Name:KAVI, MADHURI (DMD)
Entity Type:Individual
Prefix:DR
First Name:MADHURI
Middle Name:
Last Name:KAVI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:MADHURI
Other - Middle Name:
Other - Last Name:BHAVIKATTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:136 HIGH STREET EXT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-2056
Mailing Address - Country:US
Mailing Address - Phone:978-365-9497
Mailing Address - Fax:978-365-3542
Practice Address - Street 1:136 HIGH STREET EXT
Practice Address - Street 2:SUITE 500 AND 700
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-2056
Practice Address - Country:US
Practice Address - Phone:978-365-9497
Practice Address - Fax:978-365-3542
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154684447OtherNPI TYPE 2