Provider Demographics
NPI:1962675603
Name:THALANKI, LAKSHMI P (DMD, MS)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:P
Last Name:THALANKI
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 ELM ST NORTH/DAVIS SQ
Mailing Address - Street 2:
Mailing Address - City:N. CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1302
Mailing Address - Country:US
Mailing Address - Phone:617-625-1714
Mailing Address - Fax:
Practice Address - Street 1:182 ELM ST NORTH/DAVIS SQ
Practice Address - Street 2:
Practice Address - City:N. CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1302
Practice Address - Country:US
Practice Address - Phone:617-625-1714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA196741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics