Provider Demographics
NPI:1972745313
Name:VADLAPATLA, NEELIMA G
Entity Type:Individual
Prefix:DR
First Name:NEELIMA
Middle Name:G
Last Name:VADLAPATLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W MOCKINGBIRD LN STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6971
Mailing Address - Country:US
Mailing Address - Phone:214-630-7080
Mailing Address - Fax:214-630-7085
Practice Address - Street 1:1420 W MOCKINGBIRD LN STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-6971
Practice Address - Country:US
Practice Address - Phone:214-630-7080
Practice Address - Fax:214-630-7085
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54917122300000X
TX257111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist