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General NPI Number Information
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NPI Number | 1811127582
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Entity Type | Individual
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Provider Name | PRIYADARSHINI BOINPALLY DDS
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Gender | Female
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 410 GREENBAY RD
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City | HIGHWOOD
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State | IL
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Zip | 60040-2410
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Country | US
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Telephone | 847-230-9394
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Fax | 847-847-2792
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Provider Business Mailing Address
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Address Line | 410 GREENBAY
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City | HIGHWOOD
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State | IL
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Zip | 60040
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Country | US
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Telephone | 847-230-9394
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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 | 019.028057
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License Number State | IL
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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 | 019028057
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License Number State | IL
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