Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SOUMYA IMMELLA, DMD
Active Sole ProprietorDR. SOUMYA IMMELLA, DMD is a Pediatric Dentistry healthcare provider located in BREINIGSVILLE, Pennsylvania. NPI 1306480298 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · BREINIGSVILLE, PA
Registration Details
- NPI Number
- 1306480298
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 4, 2019 (6.8193309460155 yrs)
- Last Updated
- Mar 1, 2024
- License
-
DS042399 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1536 CROSSLAND RDBREINIGSVILLE, PA, 180311471Browse PA providers · Browse ZIP 18031
- Phone
- 4849342305
- Fax
- 6104357606
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.