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General NPI Number Information
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NPI Number | 1003733924
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Entity Type | Individual
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Provider Name | DR. ANIVARTHINI T THANIKELLA
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Gender | Female
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 2304 MIDWAY RD STE C
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City | PLANO
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State | TX
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Zip | 75093-8495
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Country | US
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Telephone | 972-473-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 13708 BLUEBERRY HILL DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-4804
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Country | US
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Telephone | 972-837-3423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 42640
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License Number State | TX
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