Provider Demographics
NPI:1679469639
Name:PRIYANKA VARAKANTAM DDS INC
Entity type:Organization
Organization Name:PRIYANKA VARAKANTAM DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARAKANTAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-972-5472
Mailing Address - Street 1:16670 CERRO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3905
Mailing Address - Country:US
Mailing Address - Phone:516-972-5472
Mailing Address - Fax:
Practice Address - Street 1:5651 SNELL AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3328
Practice Address - Country:US
Practice Address - Phone:408-840-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIYANKA VARAKANTAM DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental