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Individual
DR. JAISRI R THOPPAY
Active
Individual
DR. JAISRI R THOPPAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416527
VA
122300000X
Dentist
0411000055
VA
122300000X
Dentist
Primary
DN24372
FL
1223X2210X
Orofacial Pain Dentistry
0401416527
VA
1223X2210X
Orofacial Pain Dentistry
0411000055
VA
1223X2210X
Orofacial Pain Dentistry
DN24372
FL
125Q00000X
Oral Medicine Dentistry
0401416527
VA
125Q00000X
Oral Medicine Dentistry
0411000055
VA
125Q00000X
Oral Medicine Dentistry
DN24372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LX668
MEDICARE PTAN
FL
Enumeration date
06/20/2013
Last updated
12/30/2019
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