Provider Demographics
NPI:1578032413
Name:SHRADDHA P. KOLAPPA DDS PA
Entity Type:Organization
Organization Name:SHRADDHA P. KOLAPPA DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHRADDHA
Authorized Official - Middle Name:PATEL
Authorized Official - Last Name:KOLAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-553-3202
Mailing Address - Street 1:116 BRUSHY LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4841
Mailing Address - Country:US
Mailing Address - Phone:828-461-5900
Mailing Address - Fax:
Practice Address - Street 1:400 TEW CT STE 106
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2279
Practice Address - Country:US
Practice Address - Phone:919-553-3202
Practice Address - Fax:919-883-9742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty