Kannan, Poongkodi

Kannan, Poongkodi is an individual health care provider with primary practice located at 25647 Redwood Hwy , Cave Junction OR 97523-9332. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dental Public Health. Dental Providers / Dental Public Health is her primary health care specialty. Kannan, Poongkodi can be contacted via phone (541) 592-4111.

Contact Information

Primary practice address
25647 Redwood Hwy Cave Junction OR 97523-9332
Phone: (541) 592-4111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D9043 Oregon
Dental Providers / Dental Public Health 1223D0001X D9043 Oregon

Profile Details

NPI number 1528164563
LBN Legal business name Kannan, Poongkodi
Credentials B.D.S., D.D.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Oct 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528164563 NPPES
South Dakota MEDICAID 7806250

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