Provider Demographics
NPI:1982815999
Name:PUTTAGUNTA, DIVIJANI DENDI (MD)
Entity Type:Individual
Prefix:DR
First Name:DIVIJANI
Middle Name:DENDI
Last Name:PUTTAGUNTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIVIJANI
Other - Middle Name:
Other - Last Name:DENDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10670 N CENTRAL EXPY STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2130
Mailing Address - Country:US
Mailing Address - Phone:214-692-8541
Mailing Address - Fax:214-242-1035
Practice Address - Street 1:10670 N CENTRAL EXPY STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2130
Practice Address - Country:US
Practice Address - Phone:214-692-8541
Practice Address - Fax:214-242-1035
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine