Provider Demographics
NPI:1356862593
Name:SEERAM, PRIYANKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:SEERAM
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 1:155 W MICHIGAN AVE STE 1017
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3917
Mailing Address - Country:US
Mailing Address - Phone:734-358-9603
Mailing Address - Fax:
Practice Address - Street 1:5475 BECKLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4146
Practice Address - Country:US
Practice Address - Phone:269-979-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010223381223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice