Provider Demographics
NPI:1851530737
Name:ALAGIRISAMY, KIRUTHIKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIRUTHIKA
Middle Name:
Last Name:ALAGIRISAMY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 CLARIDON DR
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7164
Mailing Address - Country:US
Mailing Address - Phone:412-736-2277
Mailing Address - Fax:
Practice Address - Street 1:129 HILLCREST SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3504
Practice Address - Country:US
Practice Address - Phone:724-337-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022979230003Medicaid