Individual
DR. POONGKODI KANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S., D.D.S.
Contact information
Practice address
25647 REDWOOD HWY, CAVE JUNCTION, OR 97523-9332
(541) 592-4111
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 479-6393
(541) 479-6489
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
D9043
OR
1223G0001X
General Practice Dentistry
D9043
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7806250
—
SD
Enumeration date
09/16/2006
Last updated
10/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us