Provider Demographics
NPI:1730275272
Name:NANDEESH, ANUPAMA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANUPAMA
Middle Name:
Last Name:NANDEESH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANUPAMA
Other - Middle Name:
Other - Last Name:HALAPPA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANU NANDEESH DDS
Mailing Address - Street 1:2913 AMIR PL
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8724
Mailing Address - Country:US
Mailing Address - Phone:209-918-8862
Mailing Address - Fax:
Practice Address - Street 1:1616 FULKERTH RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-656-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist