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NPI Code Detail

MEDICARE: DR. ASHA PARVATHI LALLA D.D.S

MEDICARE:  DR. ASHA PARVATHI LALLA  D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD12171MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528159456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHA PARVATHI LALLA D.D.S
Provider Business Mailing Address
First Line : 3152 MINNEHAHA AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2774
Country : US
Telephone Number : 612-728-8888
Fax Number : 612-724-2737
Provider Business Practice Location Address
First Line : 3152 MINNEHAHA AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2774
Country : US
Telephone Number : 612-728-8888
Fax Number : 612-724-2737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/09/2007

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