Healthcare Provider Details

I. General information

NPI: 1265813265
Provider Name (Legal Business Name): APARNA R PUVVULA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14880 WHITTIER BLVD
WHITTIER CA
90605-1727
US

IV. Provider business mailing address

14880 WHITTIER BLVD
WHITTIER CA
90605-1727
US

V. Phone/Fax

Practice location:
  • Phone: 714-388-8724
  • Fax:
Mailing address:
  • Phone: 714-388-8724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number64547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: