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General NPI Number Information
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NPI Number | 1922740786
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Entity Type | Individual
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Provider Name | JULIANNE ANDRADE DDS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2154 GOODMAN RD W # 1
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City | HORN LAKE
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State | MS
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Zip | 38637-1303
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Country | US
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Telephone | 662-393-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 KALMIA DR
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City | DAYTON
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State | MD
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Zip | 21036-1233
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Country | US
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Telephone | 703-867-9957
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 063535
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License Number State | NY
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