Provider Demographics
NPI:1124333265
Name:TADINADA, SATYASHANKARA ADITYA (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:SATYASHANKARA
Middle Name:ADITYA
Last Name:TADINADA
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:UCONN SCHOOL OF DENTAL MEDICINE
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1956
Mailing Address - Country:US
Mailing Address - Phone:860-679-2207
Mailing Address - Fax:860-679-1899
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-3571
Practice Address - Country:US
Practice Address - Phone:860-679-3415
Practice Address - Fax:860-679-7507
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0105191223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology