person
Sireesha Kodali, DMD
Pediatric Dentist in Phoenix, Arizona
NPI 1447608443

Sireesha Kodali is a Pediatric Dentist based in Phoenix, AZ and is specialized in Pediatric Dentistry. Sireesha Kodali practices in Phoenix, AZ and has the professional credentials of DMD. The NPI Number for Sireesha Kodali is 1447608443 and holds a License No. 9770 (Arizona).

The current practice location address for Sireesha Kodali is 4145 N 108Th Ave, Phoenix, AZ and can be reached out via phone at 623-344-2000 and via fax at 623-344-3007.

Location: 4145 N 108Th Ave, Phoenix, AZ, 85024-5231
person
Provider Profile Details
NPI Number
1447608443
Provider Name
Sireesha Kodali
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
4145 N 108Th Ave, Phoenix, AZ, 85024-5231
Phone Number
623-344-2000
Fax Number
623-344-3007
Provider Enumeration Date
05/31/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4145 N 108Th Ave
City
State
Zip
85037
Phone Number
623-344-2000
Fax Number
623-344-3007
person
Provider Business Mailing Address Details
Address
4145 N 108Th Ave
City
State
Zip
85037
Phone Number
623-344-2000
Fax Number
623-344-3007
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
9876 (Arizona)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
9770 (Kentucky)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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