Provider Demographics
NPI:1902368129
Name:STHANAM, MEGHANA (DMD)
Entity type:Individual
Prefix:DR
First Name:MEGHANA
Middle Name:
Last Name:STHANAM
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 1:1528 21ST WAY S APT 1
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-5062
Mailing Address - Country:US
Mailing Address - Phone:205-999-1014
Mailing Address - Fax:
Practice Address - Street 1:2708 OLD ELM HILL PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3150
Practice Address - Country:US
Practice Address - Phone:615-885-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice