Provider Demographics
NPI:1184212524
Name:DIPALI NIGUDKAR DMD PLLC
Entity Type:Organization
Organization Name:DIPALI NIGUDKAR DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIPALI
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGUDKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-412-0610
Mailing Address - Street 1:1206 E MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3983
Mailing Address - Country:US
Mailing Address - Phone:469-854-8585
Mailing Address - Fax:
Practice Address - Street 1:1206 E MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3983
Practice Address - Country:US
Practice Address - Phone:469-854-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty