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General NPI Number Information
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NPI Number | 1356075295
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Entity Type | Organization
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Legal Business Name | AK DENTAL PLLC
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 7010 W HIGHWAY 71 STE 225
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City | AUSTIN
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State | TX
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Zip | 78735-8341
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Country | US
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Telephone | 732-428-9958
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Fax |
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Provider Business Mailing Address
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Address Line | 16301 DONOHER DR
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City | AUSTIN
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State | TX
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Zip | 78717-4203
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Country | US
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Telephone | 732-318-2848
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DEVISREE NEKKANTI
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Credential | D.M.D
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Telephone | 732-428-9958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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