Provider Demographics
NPI:1447426150
Name:SAMBARAJU, HARITHA (DDS)
Entity Type:Individual
Prefix:
First Name:HARITHA
Middle Name:
Last Name:SAMBARAJU
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 1:230 N DENTON TAP RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2134
Mailing Address - Country:US
Mailing Address - Phone:972-393-9933
Mailing Address - Fax:972-393-3406
Practice Address - Street 1:230 N DENTON TAP RD
Practice Address - Street 2:SUITE 115
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2134
Practice Address - Country:US
Practice Address - Phone:972-393-9933
Practice Address - Fax:972-393-3406
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist