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Contact Information

SREENIVAS KOKA, DDS
201 BAKER BLVD
LELAND, MS38756-3401
 Phone: 662-686-4121
 Fax: 662-686-4770
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthodontics

1223P0700X
Indicates primary specialty

NPI Profile & details for SREENIVAS KOKA · (Male)

NPI Number 1699753319
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 01/03/2006
Last updated 11/05/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CA License # 63470
  • MN Medicaid 587433500
  • WI Medicaid 33828500
  • MN Other P00918769 RAILROAD MEDICARE
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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