Vallabhaneni, Gopichand
Vallabhaneni, Gopichand is an individual health care provider with primary practice located at 617 Riverside Ave , Burlington VT 05401-1601. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Vallabhaneni, Gopichand can be contacted via phone (802) 864-6309.Contact Information
Primary practice address
617 Riverside Ave
Burlington VT 05401-1601
Phone: (802) 864-6309
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0160002181 | Vermont |
Profile Details
| NPI number | 1376638536 |
|---|---|
| LBN Legal business name | Vallabhaneni, Gopichand |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Nov 26th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376638536 | NPPES |
| Vermont | Other | 0160002181 | STATE LICENSE |
| Vermont | MEDICAID | 1010394 | STATE LICENSE |
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