Provider Demographics
NPI:1609522812
Name:SRINIVAS DMD & ASSOCIATES PLLC
Entity type:Organization
Organization Name:SRINIVAS DMD & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:MANDALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-446-3131
Mailing Address - Street 1:1481 RICHARDSON RD STE 111
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-8073
Mailing Address - Country:US
Mailing Address - Phone:919-446-3131
Mailing Address - Fax:919-746-7588
Practice Address - Street 1:1481 RICHARDSON RD STE 111
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-8073
Practice Address - Country:US
Practice Address - Phone:919-446-3131
Practice Address - Fax:919-746-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental