Provider Demographics
NPI:1023206786
Name:UPPALURI, SMITHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SMITHA
Middle Name:
Last Name:UPPALURI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 W NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-6218
Mailing Address - Country:US
Mailing Address - Phone:214-352-7668
Mailing Address - Fax:214-352-7670
Practice Address - Street 1:2924 W. NORTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220
Practice Address - Country:US
Practice Address - Phone:214-352-7668
Practice Address - Fax:214-352-7670
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0023606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist