Provider Demographics
NPI:1528722477
Name:SUBRAMANIAN, YAMUNA DEVI (DMD)
Entity type:Individual
Prefix:DR
First Name:YAMUNA DEVI
Middle Name:
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:YAMUNA DEVI
Other - Middle Name:
Other - Last Name:SUBRAMANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:109 POLLEN DR
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3211
Mailing Address - Country:US
Mailing Address - Phone:617-797-2710
Mailing Address - Fax:
Practice Address - Street 1:1900 OPITZ BLVD STE C
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3320
Practice Address - Country:US
Practice Address - Phone:703-494-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014176481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice