Provider Demographics
NPI:1881775385
Name:APPANNAGARI, KANTHI J (DDS)
Entity type:Individual
Prefix:DR
First Name:KANTHI
Middle Name:J
Last Name:APPANNAGARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17400 IRVINE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3030
Mailing Address - Country:US
Mailing Address - Phone:714-371-0776
Mailing Address - Fax:714-371-0179
Practice Address - Street 1:17400 IRVINE BLVD STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3030
Practice Address - Country:US
Practice Address - Phone:714-371-0776
Practice Address - Fax:714-371-0179
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA442861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice