Panchumarti, Anala

Panchumarti, Anala is an sole proprietor health care provider with primary practice located at 4714 N Armenia Ave Suite 102, Tampa FL 33603-2603. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Panchumarti, Anala can be contacted via phone (813) 876-1200.

Contact Information

Primary practice address
4714 N Armenia Ave Suite 102 Tampa FL 33603-2603
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN 18085 Florida
Dental Providers / General Practice 1223G0001X 22227 Texas

Profile Details

NPI number 1518920909
LBN Legal business name Panchumarti, Anala
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2006
Last updated Oct 5th, 2012 - about 12 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 1518920909 NPPES
Texas MEDICAID 175189301

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