Provider Demographics
NPI:1770607236
Name:N. RAO KOPURI, BDS.,MS.,PA.
Entity type:Organization
Organization Name:N. RAO KOPURI, BDS.,MS.,PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:N
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:KOPURI
Authorized Official - Suffix:
Authorized Official - Credentials:BDS,MS
Authorized Official - Phone:321-427-3000
Mailing Address - Street 1:7260 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6750
Mailing Address - Country:US
Mailing Address - Phone:407-294-1560
Mailing Address - Fax:407-294-1099
Practice Address - Street 1:7260 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6750
Practice Address - Country:US
Practice Address - Phone:407-294-1560
Practice Address - Fax:407-294-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP000000941341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty