Provider Demographics
NPI:1497074884
Name:KRISHNAPURAM, HARINI A (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARINI
Middle Name:A
Last Name:KRISHNAPURAM
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 1:20395 PACIFICA DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20395 PACIFICA DR
Practice Address - Street 2:SUITE 109
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3016
Practice Address - Country:US
Practice Address - Phone:408-873-0802
Practice Address - Fax:408-873-0804
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice