# DR.PADMAJA YALAMANCHILI DDS PC

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

## Provider details

- **NPI number:** 1174873764
- **Authorized official:** DR. PADMAJA YALAMANCHILI (PRESIDENT)
- **Authorized official phone:** (703) 386-6269

## Contact information

- **Practice address:** 10875 MAIN ST, SUITE \#103, FAIRFAX, VA 22030-4732
- **Practice address phone:** (703) 591-4010
- **Practice address fax:** (703) 591-3672
- **Mailing address:** 10875 MAIN ST, SUITE \#103, FAIRFAX, VA 22030-4732
- **Mailing address phone:** (703) 591-4010
- **Mailing address fax:** (703) 591-3672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401411072 | VA | Yes |

## Other

- **Enumeration date:** 09/11/2012
- **Last updated:** 09/11/2012