Provider Demographics
NPI:1144861295
Name:SIMHADRI, NAGA SRI KAVYA (DMD)
Entity type:Individual
Prefix:
First Name:NAGA SRI KAVYA
Middle Name:
Last Name:SIMHADRI
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 1:2 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6229
Mailing Address - Country:US
Mailing Address - Phone:978-372-1999
Mailing Address - Fax:
Practice Address - Street 1:2 WATER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6229
Practice Address - Country:US
Practice Address - Phone:978-372-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18585071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice