Provider Demographics
NPI:1104482751
Name:MURALI, SANGITA (DMD)
Entity type:Individual
Prefix:
First Name:SANGITA
Middle Name:
Last Name:MURALI
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 1:60 PERIMETER CENTER PL NE APT 516
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-4216
Mailing Address - Country:US
Mailing Address - Phone:508-789-4395
Mailing Address - Fax:
Practice Address - Street 1:80 PERIMETER CENTER PL NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-1205
Practice Address - Country:US
Practice Address - Phone:770-671-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-18
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0157161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty