Provider Demographics
NPI:1790446938
Name:AYYAPPAN, ANJALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:
Last Name:AYYAPPAN
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 1:5259 GROSSETO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2602
Mailing Address - Country:US
Mailing Address - Phone:408-410-6085
Mailing Address - Fax:
Practice Address - Street 1:1725 BERRYESSA RD STE B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1173
Practice Address - Country:US
Practice Address - Phone:408-259-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice