Provider Demographics
NPI:1073006441
Name:VADLAMUDI, YASODHARA DEVI (DDS)
Entity Type:Individual
Prefix:DR
First Name:YASODHARA DEVI
Middle Name:
Last Name:VADLAMUDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 SENANDER CRES
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-3726
Mailing Address - Country:US
Mailing Address - Phone:219-218-0052
Mailing Address - Fax:
Practice Address - Street 1:4849 SENANDER CRES
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-3726
Practice Address - Country:US
Practice Address - Phone:219-218-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN234561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice