Provider Demographics
NPI:1376615583
Name:ONELA, ANDREW SOMTHALA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SOMTHALA
Last Name:ONELA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SOMTHALA
Other - Middle Name:
Other - Last Name:ONELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2727 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2956
Mailing Address - Country:US
Mailing Address - Phone:414-383-5500
Mailing Address - Fax:414-383-5400
Practice Address - Street 1:2727 W CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-2956
Practice Address - Country:US
Practice Address - Phone:414-383-5500
Practice Address - Fax:414-383-5400
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5102-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice