Provider Demographics
NPI:1700594108
Name:VELDANDA, HARSHINI
Entity Type:Individual
Prefix:DR
First Name:HARSHINI
Middle Name:
Last Name:VELDANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7346
Mailing Address - Country:US
Mailing Address - Phone:310-990-8872
Mailing Address - Fax:
Practice Address - Street 1:1767 W OGDEN AVE STE 123
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3956
Practice Address - Country:US
Practice Address - Phone:630-983-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190340011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice