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General NPI Number Information
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NPI Number | 1679440176
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Entity Type | Organization
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Legal Business Name | EKADANTA LLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 621 RIDGELY AVE STE 202
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City | ANNAPOLIS
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State | MD
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Zip | 21401-1083
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Country | US
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Telephone | 443-535-2517
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Fax |
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Provider Business Mailing Address
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Address Line | 9975 CYPRESS WAY
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City | LAUREL
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State | MD
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Zip | 20723-6022
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Country | US
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Telephone | 443-535-2517
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Fax | 443-535-2517
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. AKSHAY VENKATESWARA KOLLURI
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Credential | DDS
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Telephone | 443-535-2517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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