Healthcare Provider Details

I. General information

NPI: 1598963092
Provider Name (Legal Business Name): MAMATHA VEERAMACHANENI D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3290 NW 10TH ST
OCALA FL
34475-4550
US

IV. Provider business mailing address

3290 NW 10TH ST
OCALA FL
34475-4550
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-6599
  • Fax:
Mailing address:
  • Phone: 352-732-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN18034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: