Provider Demographics
NPI:1134432594
Name:SANKU LAKSHMI, PRASADA VENKATA (DDS)
Entity type:Individual
Prefix:DR
First Name:PRASADA
Middle Name:VENKATA
Last Name:SANKU LAKSHMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 VETERAN'S BLVD;
Mailing Address - Street 2:AMISTAD DENTISTRY
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-3120
Mailing Address - Country:US
Mailing Address - Phone:830-775-2431
Mailing Address - Fax:830-775-7418
Practice Address - Street 1:2223 VETERAN'S BLVD;
Practice Address - Street 2:AMISTAD DENTISTRY
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3120
Practice Address - Country:US
Practice Address - Phone:830-775-2431
Practice Address - Fax:830-775-7418
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist