Provider Demographics
NPI:1386835387
Name:NIGUDKAR, DIPALI KEDAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIPALI
Middle Name:KEDAR
Last Name:NIGUDKAR
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 1:3229 CLYMER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5328
Mailing Address - Country:US
Mailing Address - Phone:617-412-0610
Mailing Address - Fax:
Practice Address - Street 1:1206 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3976
Practice Address - Country:US
Practice Address - Phone:617-412-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist