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Contact Information

AMRUTHA C MANDAVA, DMD
1662 CENTRAL AVE
ALBANY, NY12205
 Phone: 518-452-2121
 Fax: 518-456-2865
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for AMRUTHA C MANDAVA · (Male)

NPI # 1053370882
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 03/21/2006
Last updated 08/24/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 042469
  • NY Other 795808 UNITED CONCORDIA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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