Provider Demographics
NPI:1831776244
Name:TIRUPATHI DDS INC
Entity type:Organization
Organization Name:TIRUPATHI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESUDEBT
Authorized Official - Prefix:
Authorized Official - First Name:HARITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRUPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-828-9422
Mailing Address - Street 1:20600 LAKE CHABOT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5432
Mailing Address - Country:US
Mailing Address - Phone:510-538-5339
Mailing Address - Fax:
Practice Address - Street 1:20600 LAKE CHABOT RD STE 201
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5432
Practice Address - Country:US
Practice Address - Phone:510-538-5339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental