Provider Demographics
NPI:1205219896
Name:STARR, KALYANI VELLANKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KALYANI
Middle Name:VELLANKI
Last Name:STARR
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 1:2225 ROXIE ST NE
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6490
Mailing Address - Country:US
Mailing Address - Phone:704-786-0046
Mailing Address - Fax:
Practice Address - Street 1:2225 ROXIE ST NE
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6490
Practice Address - Country:US
Practice Address - Phone:704-786-0046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02605900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist