Provider Demographics
NPI:1912029661
Name:SALGUTI, DEEPIKA REDDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEEPIKA
Middle Name:REDDY
Last Name:SALGUTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 LONG PRAIRIE RD
Mailing Address - Street 2:#300
Mailing Address - City:FLOWERMOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2287
Mailing Address - Country:US
Mailing Address - Phone:469-549-4800
Mailing Address - Fax:469-549-4801
Practice Address - Street 1:4900 LONG PRAIRIE RD
Practice Address - Street 2:#300
Practice Address - City:FLOWERMOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2287
Practice Address - Country:US
Practice Address - Phone:469-549-4800
Practice Address - Fax:469-549-4801
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX-20700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist