Provider Demographics
NPI:1447308291
Name:PUROHIT, PRIYA (DDS)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:PUROHIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5505 IRON GATE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7239
Mailing Address - Country:US
Mailing Address - Phone:804-307-4567
Mailing Address - Fax:
Practice Address - Street 1:7640 HIGHWAY 70 S STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1758
Practice Address - Country:US
Practice Address - Phone:615-840-7375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0022531223P0221X
TN99541223P0221X, 1223G0001X
IL019.027292122300000X
VA04014115171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9184874Medicaid
TNQ012465Medicaid