Provider Demographics
NPI:1720338056
Name:INDRAKANTI, NAGARAJU RASHMI (DMD)
Entity Type:Individual
Prefix:
First Name:NAGARAJU RASHMI
Middle Name:
Last Name:INDRAKANTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S MAYS ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6740
Mailing Address - Country:US
Mailing Address - Phone:512-248-8888
Mailing Address - Fax:512-733-0000
Practice Address - Street 1:1715 S MAYS ST STE E
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6740
Practice Address - Country:US
Practice Address - Phone:512-248-8888
Practice Address - Fax:512-733-0000
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28421122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist