Provider Demographics
NPI:1134807308
Name:SUBBAKARAN, RESHIKA (DDS)
Entity type:Individual
Prefix:DR
First Name:RESHIKA
Middle Name:
Last Name:SUBBAKARAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 GRAMERCY PL
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-7051
Mailing Address - Country:US
Mailing Address - Phone:603-568-5190
Mailing Address - Fax:
Practice Address - Street 1:32 NORTHEAST DR STE 202
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2758
Practice Address - Country:US
Practice Address - Phone:717-533-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist