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SHREE ANITHA PRASANNA PA INC NPI 1194199364


NPI Information

NPI: 1194199364
Provider Name: SHREE ANITHA PRASANNA PA INC

Doing Business As: SPACE COAST DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1490 CHENEY HWY
TITUSVILLE, FL
ZIP 32780
Phone: (321) 267-3304
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SHREE ANITHA PRASANNA PA INC is a general practice dentist in Titusville, FL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SHREE ANITHA PRASANNA PA INC NPI is 1194199364. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Space Coast Dentistry.

The provider's business location address is:

1490 CHENEY HWY
TITUSVILLE, FL
ZIP 32780-250
Phone: (321) 267-3304
Fax: (321) 267-9191

The provider's authorized official is Glenna Morris .
The authorized official title is Administrator Officer and has the following contact phone number (321) 268-0108.

The enumeration date for this NPI number is 11/25/2015 and was last updated on 2/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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