Provider Demographics
NPI:1629568522
Name:DEVAKI, SWATHI (DDS)
Entity Type:Individual
Prefix:
First Name:SWATHI
Middle Name:
Last Name:DEVAKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7049 WESTWIND DR APT 1101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:780 SCENIC DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4304
Practice Address - Country:US
Practice Address - Phone:575-437-8994
Practice Address - Fax:575-437-8994
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD4949122300000X
AZD011720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist