Provider Demographics
NPI:1972026649
Name:BONDALAPATI, ANNAPURNA (BDS, MS)
Entity Type:Individual
Prefix:
First Name:ANNAPURNA
Middle Name:
Last Name:BONDALAPATI
Suffix:
Gender:F
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219B SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-2132
Mailing Address - Country:US
Mailing Address - Phone:540-252-2159
Mailing Address - Fax:
Practice Address - Street 1:219B SOUTH ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-2132
Practice Address - Country:US
Practice Address - Phone:540-252-2159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014157691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry