Provider Demographics
NPI:1669219283
Name:VEMPATI, SWETHA DEEKSHITULU (BDS, MS, DDS)
Entity type:Individual
Prefix:DR
First Name:SWETHA
Middle Name:DEEKSHITULU
Last Name:VEMPATI
Suffix:
Gender:F
Credentials:BDS, MS, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 MARVIN RD NE STE D
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-3878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 MARVIN RD NE STE D
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-3878
Practice Address - Country:US
Practice Address - Phone:360-873-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.61564398122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist