Provider Demographics
NPI:1063818672
Name:DOPPALAPUDI, NALINI (DMD)
Entity Type:Individual
Prefix:
First Name:NALINI
Middle Name:
Last Name:DOPPALAPUDI
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 1:15 SUNDOWN DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1741
Mailing Address - Country:US
Mailing Address - Phone:205-747-0131
Mailing Address - Fax:
Practice Address - Street 1:15 SUNDOWN DR UNIT B
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1741
Practice Address - Country:US
Practice Address - Phone:205-747-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856772122300000X
CT114911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist