Provider Demographics
NPI:1518214428
Name:ENUGANTI, NARAYANA RAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:NARAYANA
Middle Name:RAO
Last Name:ENUGANTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 WINDFORD DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2070
Mailing Address - Country:US
Mailing Address - Phone:419-434-0841
Mailing Address - Fax:
Practice Address - Street 1:1880 W MOORE AVE STE 7
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2365
Practice Address - Country:US
Practice Address - Phone:972-563-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD37461223G0001X
TX285851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice