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General NPI Number Information
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NPI Number | 1598084352
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Entity Type | Individual
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Provider Name | DR. ANUBAMA SRI
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Gender | Female
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 729 SUNRISE AVE STE. 101
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City | ROSEVILLE
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State | CA
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Zip | 95661-4565
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Country | US
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Telephone | 916-781-3737
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Fax | 916-781-6648
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Provider Business Mailing Address
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Address Line | 729 SUNRISE AVE STE. 101
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City | ROSEVILLE
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State | CA
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Zip | 95661-4565
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Country | US
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Telephone | 916-781-3737
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 59035
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 60704
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2009020515
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License Number State | MO
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