Provider Demographics
NPI:1124911847
Name:MULBERRY DENTAL, PLLC
Entity type:Organization
Organization Name:MULBERRY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARIMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAHALAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-656-0146
Mailing Address - Street 1:412 PARKMAN GRANT DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6133
Mailing Address - Country:US
Mailing Address - Phone:919-656-0146
Mailing Address - Fax:888-377-6361
Practice Address - Street 1:1911 FALLS VALLEY DR STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2496
Practice Address - Country:US
Practice Address - Phone:919-656-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental