Provider Demographics
NPI:1588811905
Name:UPPUTURI, SHARADA (DDS)
Entity Type:Individual
Prefix:MS
First Name:SHARADA
Middle Name:
Last Name:UPPUTURI
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 1:7045 VETERANS BLVD.
Mailing Address - Street 2:A-1
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5605
Mailing Address - Country:US
Mailing Address - Phone:708-354-0835
Mailing Address - Fax:630-325-5176
Practice Address - Street 1:7045 VETERANS BLVD.
Practice Address - Street 2:A-1
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5605
Practice Address - Country:US
Practice Address - Phone:708-354-0835
Practice Address - Fax:630-325-5176
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist