Healthcare Provider Details
I. General information
NPI: 1275218463
Provider Name (Legal Business Name): SRINITHA SINGANAMALA BDS,MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2023
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7660 S MCCLINTOCK DR
TEMPE AZ
85284-1632
US
IV. Provider business mailing address
7660 S MCCLINTOCK DR
TEMPE AZ
85284-1632
US
V. Phone/Fax
- Phone: 469-412-2053
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | D012756 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: