Provider Demographics
NPI:1831814243
Name:CHALLAPALLI, PRASANTHI (DMD)
Entity type:Individual
Prefix:
First Name:PRASANTHI
Middle Name:
Last Name:CHALLAPALLI
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 1:2701 ATLANTA DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-1509
Mailing Address - Country:US
Mailing Address - Phone:281-814-6576
Mailing Address - Fax:
Practice Address - Street 1:802 E AMARILLO BLVD STE 300
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5401
Practice Address - Country:US
Practice Address - Phone:806-230-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist