Provider Demographics
NPI:1518129410
Name:ANGARA, SRI LAKSHMI (DDS)
Entity type:Individual
Prefix:
First Name:SRI LAKSHMI
Middle Name:
Last Name:ANGARA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4794
Mailing Address - Country:US
Mailing Address - Phone:609-278-5900
Mailing Address - Fax:844-601-8848
Practice Address - Street 1:112 EWING ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1004
Practice Address - Country:US
Practice Address - Phone:609-278-5900
Practice Address - Fax:844-601-8848
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023707001223G0001X
PADS0375061223G0001X
NJ22DI023707031223G0001X
NJ22DI023707011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0221562Medicaid