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General NPI Number Information
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NPI Number | 1174768931
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Entity Type | Individual
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Provider Name | PADMAJA KROTHAPALLI
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Gender | Female
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1 COLLEGE ST
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City | PORTLAND
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State | ME
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Zip | 04103-2617
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Country | US
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Telephone | 207-221-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 25 NASHUA RD UNIT D1
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City | LONDONDERRY
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State | NH
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Zip | 03053-3446
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Country | US
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Telephone | 617-432-6430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DEN5297
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 04176
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DL10511
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License Number State | MA
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