Provider Demographics
NPI:1447545553
Name:KAPUR, SUVIKA (DMD)
Entity type:Individual
Prefix:DR
First Name:SUVIKA
Middle Name:
Last Name:KAPUR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SUVIKA
Other - Middle Name:KAPUR
Other - Last Name:VIRMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:205 VERNON AVE
Mailing Address - Street 2:#227
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4348
Mailing Address - Country:US
Mailing Address - Phone:706-631-2740
Mailing Address - Fax:
Practice Address - Street 1:330 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1860
Practice Address - Country:US
Practice Address - Phone:860-899-2804
Practice Address - Fax:860-899-2803
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT010553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist