Provider Demographics
NPI:1114697729
Name:NEELI, RAMYA PRIYA (DDS)
Entity Type:Individual
Prefix:
First Name:RAMYA
Middle Name:PRIYA
Last Name:NEELI
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 1:271 CALE CT
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:IL
Mailing Address - Zip Code:62535
Mailing Address - Country:US
Mailing Address - Phone:217-475-1558
Mailing Address - Fax:
Practice Address - Street 1:VOGUE DENTAL
Practice Address - Street 2:305 S LINDEN ST, STE. 101
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761
Practice Address - Country:US
Practice Address - Phone:309-306-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist