Provider Demographics
NPI:1609280817
Name:BANGALORE, SHEELA (DMD)
Entity type:Individual
Prefix:DR
First Name:SHEELA
Middle Name:
Last Name:BANGALORE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 MONTVALE GRANT WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1017
Mailing Address - Country:US
Mailing Address - Phone:949-923-8477
Mailing Address - Fax:
Practice Address - Street 1:3434 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-2277
Practice Address - Country:US
Practice Address - Phone:919-629-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist