Provider Demographics
NPI:1851966659
Name:UPPALAPATI, KAUSHIKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAUSHIKI
Middle Name:
Last Name:UPPALAPATI
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 1:11023 SE 240TH ST UNIT H1
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-4906
Mailing Address - Country:US
Mailing Address - Phone:253-487-9010
Mailing Address - Fax:
Practice Address - Street 1:11023 SE 240TH ST UNIT H1
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-4906
Practice Address - Country:US
Practice Address - Phone:253-487-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61175667122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE61175667OtherWASHINGTON STATE DENTIST LICENSE NUMBER