Individual
MR. SUNDARALINGAM PREMARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MS, PHD
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
(502) 852-2621
Mailing address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
112
NE
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-00163
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DTP759
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4562
BC/BS
NE
01
—
DTP759
FLORIDA DENTAL TEACHING PERMIT
FL
Enumeration date
01/23/2007
Last updated
04/06/2026
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