Provider Demographics
NPI:1154779684
Name:MALLAVARAPU, LAKSHMI HARINI (DDS)
Entity type:Individual
Prefix:
First Name:LAKSHMI HARINI
Middle Name:
Last Name:MALLAVARAPU
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 1:3360 W CACTUS AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-8810
Mailing Address - Country:US
Mailing Address - Phone:702-781-8756
Mailing Address - Fax:
Practice Address - Street 1:3360 W CACTUS AVE STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-8810
Practice Address - Country:US
Practice Address - Phone:702-781-8756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-4694122300000X
KS61492122300000X
MO2019020332122300000X
NV8230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist