Golla, Keerthi

Golla, Keerthi is an individual health care provider with primary practice located at 539 Madison Ter , Sunnyvale CA 94087-4872. She recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Golla, Keerthi can be contacted via phone (732) 648-1166.

Contact Information

Primary practice address
539 Madison Ter Sunnyvale CA 94087-4872
Phone: (732) 648-1166
Fax: (732) 648-1166
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 100398 California
Dental Providers / Pediatric Dentistry 1223P0221X 021002442 Illinois
Dental Providers / General Practice 1223G0001X 052386 New York

Profile Details

NPI number 1528045184
LBN Legal business name Golla, Keerthi
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2005
Last updated Apr 6th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528045184 NPPES
New York MEDICAID 02678619

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