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General NPI Number Information
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NPI Number | 1851487078
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Entity Type | Individual
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Provider Name | SREE LAKSHMI NADELLA DDS
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 16429 N 105TH WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-9035
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Country | US
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Telephone | 404-660-4856
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Fax |
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Provider Business Mailing Address
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Address Line | 16429 N 105TH WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-9035
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Country | US
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Telephone | 404-660-4856
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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 | 9014
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License Number State | NC
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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 | 013022
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008580
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License Number State | AZ
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