Provider Demographics
NPI:1124818232
Name:VANAM, JAGRITI (DDS)
Entity type:Individual
Prefix:
First Name:JAGRITI
Middle Name:
Last Name:VANAM
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SHURLING PL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7588
Mailing Address - Country:US
Mailing Address - Phone:919-601-2997
Mailing Address - Fax:
Practice Address - Street 1:2945 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1213
Practice Address - Country:US
Practice Address - Phone:919-834-4932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program