Provider Demographics
NPI:1275734634
Name:HULLUR, VEENA
Entity Type:Individual
Prefix:DR
First Name:VEENA
Middle Name:
Last Name:HULLUR
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:VEENA
Other - Middle Name:
Other - Last Name:VAMADEV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1035 SITKA TERRACE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-1171
Mailing Address - Country:US
Mailing Address - Phone:408-746-9348
Mailing Address - Fax:408-746-9348
Practice Address - Street 1:1035 SITKA TER
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6800
Practice Address - Country:US
Practice Address - Phone:408-746-9348
Practice Address - Fax:408-746-9348
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD55272Medicaid