Provider Demographics
NPI:1407030232
Name:MEENA CHELURY, D.D.S., P.A.
Entity Type:Organization
Organization Name:MEENA CHELURY, D.D.S., P.A.
Other - Org Name:AMBERLY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHELURY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-467-0550
Mailing Address - Street 1:404 MANNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6863
Mailing Address - Country:US
Mailing Address - Phone:919-619-7898
Mailing Address - Fax:
Practice Address - Street 1:1130, GREEN LEVEL TO DURHAM RD, SUITE 302
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:919-467-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty