Provider Demographics
NPI:1154492973
Name:PRASAD, NEELANJANI S (DMD, MMSC , PA)
Entity Type:Individual
Prefix:DR
First Name:NEELANJANI
Middle Name:S
Last Name:PRASAD
Suffix:
Gender:F
Credentials:DMD, MMSC , PA
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Mailing Address - Street 1:1701 LEGACY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5989
Mailing Address - Country:US
Mailing Address - Phone:214-618-8240
Mailing Address - Fax:214-618-8243
Practice Address - Street 1:1701 LEGACY DR STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5989
Practice Address - Country:US
Practice Address - Phone:214-618-8240
Practice Address - Fax:214-618-8243
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX199321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics