IndividualActive
Sivaraman Prakasam, B.D.S, M.S.D., PHD
NPI 1720338296 · Periodontics · Iowa City, IA
Provider details
- NPI number
- 1720338296
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- B.D.S, M.S.D., PHD
- Sex
- Male
- Sole proprietor
- No
- License
- 98000607A (IN)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
801 Newton Rd
Iowa City, IA 52242-1001
Phone: (319) 335-7440
Fax: (319) 335-7451
Approximate (ZIP-level) locationGet directions
Mailing address
322 Dental Science Bldg S
Iowa City, IA 52242-1001
Additional practice locations (1)
- 1121 W Michigan StSte # 422Indianapolis, IN 46202-5211Phone: (317) 274-0378Fax: (317) 274-1363
Registry dates
- Enumerated
- 2012-09-12
- Last updated
- 2023-10-25
- Certified
- 2023-10-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.