Golla, Keerthi
Golla, Keerthi is an individual health care provider with primary practice located at 539 Madison Ter , Sunnyvale CA 94087-4872. She recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Golla, Keerthi can be contacted via phone (732) 648-1166.Contact Information
Primary practice address
539 Madison Ter
Sunnyvale CA 94087-4872
Phone: (732) 648-1166
Fax: (732) 648-1166
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 100398 | California |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 021002442 | Illinois |
| Dental Providers / General Practice | 1223G0001X | 052386 | New York |
Profile Details
| NPI number | 1528045184 |
|---|---|
| LBN Legal business name | Golla, Keerthi |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 26th, 2005 |
| Last updated | Apr 6th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528045184 | NPPES |
| New York | MEDICAID | 02678619 |
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