Provider Demographics
NPI:1164945044
Name:PALLOD, AKSHAYA (DDS)
Entity Type:Individual
Prefix:
First Name:AKSHAYA
Middle Name:
Last Name:PALLOD
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 1:1447 WINDING BROOK CIR APT 292
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2924
Mailing Address - Country:US
Mailing Address - Phone:214-679-1987
Mailing Address - Fax:
Practice Address - Street 1:8702 S LANCASTER RD STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-6317
Practice Address - Country:US
Practice Address - Phone:972-349-6249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice