Provider Demographics
NPI:1184807711
Name:KATTA, NEELIMA (DDS)
Entity type:Individual
Prefix:DR
First Name:NEELIMA
Middle Name:
Last Name:KATTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NEELIMA
Other - Middle Name:
Other - Last Name:POTLURI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:21700 COLONY PARK CIR APT 205
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1682
Mailing Address - Country:US
Mailing Address - Phone:248-351-0879
Mailing Address - Fax:
Practice Address - Street 1:21700 COLONY PARK CIR APT 205
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1682
Practice Address - Country:US
Practice Address - Phone:248-351-0879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56543122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist