Provider Demographics
NPI:1033591193
Name:NAIDU, AANVI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AANVI
Middle Name:
Last Name:NAIDU
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 1:12901 N INTERSTATE 35 # 2000
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1019
Mailing Address - Country:US
Mailing Address - Phone:512-568-3498
Mailing Address - Fax:
Practice Address - Street 1:12901 N IH 35 STE 2000
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1019
Practice Address - Country:US
Practice Address - Phone:512-568-3498
Practice Address - Fax:512-568-3499
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6725122300000X
TX31062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist