SIREESHA PENUMETCHA DDS PC NPI 1861118580

NPI Information

NPI: 1861118580
Provider Name: SIREESHA PENUMETCHA, DDS PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4720 ELK GROVE BLVD STE 170
ELK GROVE, CA
ZIP 95758
Phone: (916) 691-9191
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SIREESHA PENUMETCHA, DDS PC is a dental clinic center in Elk Grove, CA. SIREESHA PENUMETCHA, DDS PC NPI is 1861118580. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4720 ELK GROVE BLVD STE 170
ELK GROVE, CA
ZIP 95758-185
Phone: (916) 691-9191

The provider's authorized official is Sireesha Penumetcha .
The authorized official title is President and has the following contact phone number (916) 691-9191.

The enumeration date for this NPI number is 10/14/2022 and was last updated on 10/14/2022.

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	Primary
1	122300000X	Dentist		No
2	1223G0001X	Dentist	General Practice	No
3	1223S0112X	Dentist	Oral and Maxillofacial Surgery	No
4	261QD0000X	Clinic/Center	Dental	Yes

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

NPI Synchronization or Removal

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