Healthcare Provider Details

I. General information

NPI: 1124911847
Provider Name (Legal Business Name): PARIMALA PRAHALAD D.M.D., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 FALLS VALLEY DR STE 107
RALEIGH NC
27615-2496
US

IV. Provider business mailing address

412 PARKMAN GRANT DR
CARY NC
27519-6133
US

V. Phone/Fax

Practice location:
  • Phone: 919-656-0146
  • Fax:
Mailing address:
  • Phone: 919-656-0146
  • Fax: 888-377-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PARIMALA PRAHALAD
Title or Position: PRESIDENT
Credential: DMD
Phone: 919-656-0146