Provider Demographics
NPI:1730313511
Name:MURLIDHARRAO, KAVITA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:
Last Name:MURLIDHARRAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KAVITA
Other - Middle Name:
Other - Last Name:KULKARNI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6 TERRELL FARMS WAY
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2077
Mailing Address - Country:US
Mailing Address - Phone:203-265-9359
Mailing Address - Fax:
Practice Address - Street 1:6 TERRELL FARMS WAY
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2077
Practice Address - Country:US
Practice Address - Phone:203-265-9359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0088631223G0001X, 1223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry