Provider Demographics
NPI:1386783751
Name:SINHA, PALLAVI (DMD)
Entity type:Individual
Prefix:DR
First Name:PALLAVI
Middle Name:
Last Name:SINHA
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 1:12486 TESSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2702
Mailing Address - Country:US
Mailing Address - Phone:314-843-5533
Mailing Address - Fax:314-843-4801
Practice Address - Street 1:12486 TESSON FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2702
Practice Address - Country:US
Practice Address - Phone:314-843-5533
Practice Address - Fax:314-843-4801
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004025287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO409298726Medicaid