Provider Demographics
NPI:1831238609
Name:VEERABHADRAIAH, HAREESH (DDS)
Entity type:Individual
Prefix:DR
First Name:HAREESH
Middle Name:
Last Name:VEERABHADRAIAH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:HAREESH
Other - Middle Name:
Other - Last Name:VEERABHADRAIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:391 WILKERSON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2254
Mailing Address - Country:US
Mailing Address - Phone:951-943-4007
Mailing Address - Fax:951-943-1037
Practice Address - Street 1:391 WILKERSON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2254
Practice Address - Country:US
Practice Address - Phone:951-943-4007
Practice Address - Fax:951-943-1037
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice