Provider Demographics
NPI:1538284302
Name:SRIPATHI, GEETHA (DMD)
Entity Type:Individual
Prefix:
First Name:GEETHA
Middle Name:
Last Name:SRIPATHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3548 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8819
Mailing Address - Country:US
Mailing Address - Phone:919-388-0137
Mailing Address - Fax:
Practice Address - Street 1:3548 DAVIS DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8819
Practice Address - Country:US
Practice Address - Phone:919-388-0137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice