Provider Demographics
NPI:1225094501
Name:NAIR, UMADEVI PURUSHOTHAMAN (DMD)
Entity type:Individual
Prefix:DR
First Name:UMADEVI
Middle Name:PURUSHOTHAMAN
Last Name:NAIR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:UMA
Other - Middle Name:P
Other - Last Name:NAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1026 E WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4914
Mailing Address - Country:US
Mailing Address - Phone:972-479-5588
Mailing Address - Fax:
Practice Address - Street 1:1026 E WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4914
Practice Address - Country:US
Practice Address - Phone:972-479-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 031668L1223E0200X
FLDN 173851223E0200X
TX335491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8N7403467OtherDEA