Provider Demographics
NPI:1154981561
Name:ARUMUGAM, MADHUMIETHA (DMD)
Entity type:Individual
Prefix:DR
First Name:MADHUMIETHA
Middle Name:
Last Name:ARUMUGAM
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 1:53 COGNEWAUGH RD
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-1710
Mailing Address - Country:US
Mailing Address - Phone:201-850-7896
Mailing Address - Fax:
Practice Address - Street 1:1134 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4315
Practice Address - Country:US
Practice Address - Phone:203-973-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0421811223G0001X
NJ22DI027602001223G0001X
CT2.0125531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice