Provider Demographics
NPI:1659711984
Name:UPPALA, LAKSHMI (DDS)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:
Last Name:UPPALA
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 1:35 HUNTINGTON LN
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-6908
Mailing Address - Country:US
Mailing Address - Phone:847-229-1700
Mailing Address - Fax:847-947-8705
Practice Address - Street 1:35 HUNTINGTON LN
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-6908
Practice Address - Country:US
Practice Address - Phone:847-229-1700
Practice Address - Fax:847-947-8705
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029466122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist