Provider Demographics
NPI:1699958231
Name:EDIRISINGHE, YOLANI P (DMD)
Entity type:Individual
Prefix:DR
First Name:YOLANI
Middle Name:P
Last Name:EDIRISINGHE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3473
Mailing Address - Country:US
Mailing Address - Phone:203-878-1766
Mailing Address - Fax:
Practice Address - Street 1:53 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3473
Practice Address - Country:US
Practice Address - Phone:203-878-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT09199122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist