# KANAKA SRIRAM, D.D.S., P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104038546
- **Authorized official:** DR. KANAKA SRIRAM D.D.S. (DENTIST)
- **Authorized official phone:** (703) 255-2326

## Contact information

- **Practice address:** 410 MAPLE AVE W, SUITE 2, VIENNA, VA 22180-4240
- **Practice address phone:** (703) 255-2326
- **Mailing address:** 410 MAPLE AVE W, SUITE 2, VIENNA, VA 22180-4240
- **Mailing address phone:** (703) 255-2326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401007621 | VA | Yes |

## Other

- **Enumeration date:** 05/06/2007
- **Last updated:** 08/22/2020