Provider Demographics
NPI:1609008556
Name:KAPA, VENKATESWAR R (DMD)
Entity Type:Individual
Prefix:DR
First Name:VENKATESWAR
Middle Name:R
Last Name:KAPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 GREGS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-5555
Mailing Address - Country:US
Mailing Address - Phone:717-214-7309
Mailing Address - Fax:
Practice Address - Street 1:351 LOUCKS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404
Practice Address - Country:US
Practice Address - Phone:717-848-3600
Practice Address - Fax:717-848-3100
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2014-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0380171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice