Healthcare Provider Details

I. General information

NPI: 1487215240
Provider Name (Legal Business Name): DR. NIRANJANI KROTHAPALLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22618 ALDINE WESTFIELD RD
SPRING TX
77373-6569
US

IV. Provider business mailing address

3030 LBJ FWY STE 1400
DALLAS TX
75234-2766
US

V. Phone/Fax

Practice location:
  • Phone: 832-626-0878
  • Fax:
Mailing address:
  • Phone: 972-444-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number35246
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: