Kolluri, Akshay Venkateswara

Kolluri, Akshay Venkateswara is an individual health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Kolluri, Akshay Venkateswara can be contacted via phone (410) 651-5151.

Contact Information

Primary practice address
12165 Elm St Princess Anne MD 21853-1358
Fax: (410) 651-4256
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 17447 Maryland

Profile Details

NPI number 1780206821
LBN Legal business name Kolluri, Akshay Venkateswara
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2020
Last updated Jun 15th, 2021 - about 4 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 1780206821 NPPES
Maryland MEDICAID 119591300

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