Provider Demographics
NPI:1508128745
Name:ANUMOLU-ALAPATI, NAGA L (DDS)
Entity Type:Individual
Prefix:
First Name:NAGA
Middle Name:L
Last Name:ANUMOLU-ALAPATI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NAGA
Other - Middle Name:L
Other - Last Name:ANUMOLU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:123 N MCCREARY ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRANCH
Mailing Address - State:IN
Mailing Address - Zip Code:47648-1313
Mailing Address - Country:US
Mailing Address - Phone:812-753-1039
Mailing Address - Fax:812-753-1122
Practice Address - Street 1:123 N MCCREARY ST
Practice Address - Street 2:
Practice Address - City:FORT BRANCH
Practice Address - State:IN
Practice Address - Zip Code:47648-1313
Practice Address - Country:US
Practice Address - Phone:812-753-1039
Practice Address - Fax:812-753-1122
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011933A1223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice