Provider Demographics
NPI:1023900636
Name:AFFINITY DENTAL MUNCIE LLC
Entity type:Organization
Organization Name:AFFINITY DENTAL MUNCIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DURSHANAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:888-244-8899
Mailing Address - Street 1:200 E MCGALLIARD RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-2009
Mailing Address - Country:US
Mailing Address - Phone:765-254-1706
Mailing Address - Fax:765-254-1709
Practice Address - Street 1:200 E MCGALLIARD RD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-2009
Practice Address - Country:US
Practice Address - Phone:765-254-1706
Practice Address - Fax:765-254-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty