Provider Demographics
NPI:1801380621
Name:CHIRUMAMILLA, GEETIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEETIKA
Middle Name:
Last Name:CHIRUMAMILLA
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 1:1060 CROSSINGS CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2777
Mailing Address - Country:US
Mailing Address - Phone:773-575-9355
Mailing Address - Fax:
Practice Address - Street 1:1060 CROSSINGS CIR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2777
Practice Address - Country:US
Practice Address - Phone:773-575-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN107841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice