Provider Demographics
NPI:1427555994
Name:GUNARAJASINGAM, AYINKERAN (DMD)
Entity type:Individual
Prefix:DR
First Name:AYINKERAN
Middle Name:
Last Name:GUNARAJASINGAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 WASHINGTON STREET
Mailing Address - Street 2:409
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1875
Mailing Address - Country:US
Mailing Address - Phone:617-922-7219
Mailing Address - Fax:
Practice Address - Street 1:6 LOUDON ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:509-483-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18582311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADN1858231OtherSTATE OF MASSACHUSETTS