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General NPI Number Information
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NPI Number | 1609280817
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Entity Type | Individual
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Provider Name | SHEELA BANGALORE D.M.D
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 3434 KILDAIRE FARM RD
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City | CARY
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State | NC
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Zip | 27518-2277
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Country | US
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Telephone | 919-629-7516
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 MONTVALE GRANT WAY
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City | CARY
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State | NC
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Zip | 27519-1017
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Country | US
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Telephone | 949-923-8477
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12355
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License Number State | NC
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