Provider Demographics
NPI:1801533435
Name:NIMMAGADDA, SWETHA (DMD)
Entity type:Individual
Prefix:
First Name:SWETHA
Middle Name:
Last Name:NIMMAGADDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 PEOPLES WAY
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-1904
Mailing Address - Country:US
Mailing Address - Phone:302-489-9687
Mailing Address - Fax:
Practice Address - Street 1:1460 KELLY RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9001
Practice Address - Country:US
Practice Address - Phone:919-335-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist