Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shouvik Ponnusamy, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1457706202

Shouvik Ponnusamy, DMD is a Student in an Organized Health Care Education/Training Program in Round Rock, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4010 Sandy Brook Dr Ste 204
Round Rock, TX 78665-1518
Phone: (512) 456-3161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 38050 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1457706202
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedApril 29, 2016
Last updated in NPPESSeptember 23, 2022
Certification dateSeptember 23, 2022
Mailing address1511 Rimstone Dr, Cedar Park, TX 78613-7692

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