Provider Demographics
NPI:1194055194
Name:LAKSHMANAKUMARASAMY, YASODHADEVI (DDS)
Entity type:Individual
Prefix:
First Name:YASODHADEVI
Middle Name:
Last Name:LAKSHMANAKUMARASAMY
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 1:115 LONDON WAY
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2440 TIMBER RIDGE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5040
Practice Address - Country:US
Practice Address - Phone:408-470-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25241122300000X
CA58905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist