Provider Demographics
NPI:1063952760
Name:VIBHI VELLANKI INC
Entity type:Organization
Organization Name:VIBHI VELLANKI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUJANI
Authorized Official - Middle Name:
Authorized Official - Last Name:VELLANKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-823-1266
Mailing Address - Street 1:138 S MAIN ST
Mailing Address - Street 2:SUITE 8, NEW HORIZONS FAMILY DENTAL
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3272
Mailing Address - Country:US
Mailing Address - Phone:937-367-7826
Mailing Address - Fax:
Practice Address - Street 1:138 S MAIN ST
Practice Address - Street 2:SUITE 8, NEW HORIZONS FAMILY DENTAL
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3272
Practice Address - Country:US
Practice Address - Phone:937-367-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty