Provider Demographics
NPI:1487215240
Name:KROTHAPALLI, NIRANJANI
Entity Type:Individual
Prefix:DR
First Name:NIRANJANI
Middle Name:
Last Name:KROTHAPALLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 LBJ FWY STE 1400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2766
Mailing Address - Country:US
Mailing Address - Phone:972-444-8888
Mailing Address - Fax:
Practice Address - Street 1:10411 VETERANS MEMORIAL DR STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77038-1501
Practice Address - Country:US
Practice Address - Phone:832-399-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist