Provider Demographics
NPI:1356613566
Name:JANARTHANAN, EALACHELVI (DDS)
Entity type:Individual
Prefix:DR
First Name:EALACHELVI
Middle Name:
Last Name:JANARTHANAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHELVI
Other - Middle Name:
Other - Last Name:JANARTHANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2320 NOWATA PL
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-4744
Mailing Address - Country:US
Mailing Address - Phone:186-014-7129
Mailing Address - Fax:
Practice Address - Street 1:2320 NOWATA PL
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-4744
Practice Address - Country:US
Practice Address - Phone:918-601-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160049831223G0001X
LA62521223G0001X
OK7677122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1862525Medicaid