Provider Demographics
NPI:1568194314
Name:KOVVURI, BINDU TEJESVI
Entity Type:Individual
Prefix:
First Name:BINDU
Middle Name:TEJESVI
Last Name:KOVVURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BINDU
Other - Middle Name:TEJESVI
Other - Last Name:KARRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR
Mailing Address - Street 1:1381 E BOOT RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5934
Mailing Address - Country:US
Mailing Address - Phone:610-918-4995
Mailing Address - Fax:
Practice Address - Street 1:1381 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5934
Practice Address - Country:US
Practice Address - Phone:909-305-3989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0436101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice