Provider Demographics
NPI:1578713046
Name:INAPURI, PAVANI (DMD)
Entity Type:Individual
Prefix:
First Name:PAVANI
Middle Name:
Last Name:INAPURI
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 1:817 W WHITE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-2613
Mailing Address - Country:US
Mailing Address - Phone:214-631-9199
Mailing Address - Fax:
Practice Address - Street 1:817 W WHITE ST STE 100
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-2613
Practice Address - Country:US
Practice Address - Phone:214-631-9199
Practice Address - Fax:877-209-0956
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice