Individual
LAVANYA PERNAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS
Contact information
Practice address
2100 CHILI AVE, ROCHESTER, NY 14624-3452
(585) 275-5051
Mailing address
400 STARBOARD SIDE LN, APT 102, WEBSTER, NY 14580-2283
(585) 275-5051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
058550
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107956673
DRIVING LICENSE NUMBER
NY
Enumeration date
02/20/2013
Last updated
08/11/2016
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