Provider Demographics
NPI:1194307371
Name:SRI A DDS INC
Entity type:Organization
Organization Name:SRI A DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SRI VINAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLURI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-209-5325
Mailing Address - Street 1:3519 CORTE BELLA CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4315
Mailing Address - Country:US
Mailing Address - Phone:408-209-5325
Mailing Address - Fax:
Practice Address - Street 1:150 N JACKSON AVE STE 109
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1908
Practice Address - Country:US
Practice Address - Phone:408-209-5325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental