MEDICARE: DR. RAVICHANDRA JULURI D.D.S.,M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	8930	TN
2	1223P0300X	Periodontics	0401412308	VA

General Provider Information

NPI Number	:	1114156981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVICHANDRA JULURI D.D.S.,M.S.

Provider Business Mailing Address
First Line	:	705 HILLMEADE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-2262
Country	:	US
Telephone Number	:	646-238-6196
Fax Number	:	615-327-6246

Provider Business Practice Location Address
First Line	:	1005 DR. D. B. TODD JR. BLVD
Second Line	:	PERIODONTICS
City	:	NASHVILLE
State	:	TN
Zip	:	37208-3599
Country	:	US
Telephone Number	:	615-327-6014
Fax Number	:	615-327-6246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	07/14/2009

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