Provider Demographics
NPI:1982906160
Name:SIVENDRAN, ANUSHIA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANUSHIA
Middle Name:
Last Name:SIVENDRAN
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 1:88 LAKE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8431
Mailing Address - Country:US
Mailing Address - Phone:717-873-3949
Mailing Address - Fax:
Practice Address - Street 1:88 LAKE VIEW DR
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8431
Practice Address - Country:US
Practice Address - Phone:717-873-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist