Provider Demographics
NPI:1417011628
Name:BALARAMAN, LAKSHMI PRIYA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAKSHMI PRIYA
Middle Name:
Last Name:BALARAMAN
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 1:4207 ARROW WOOD RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4885
Mailing Address - Country:US
Mailing Address - Phone:512-966-3685
Mailing Address - Fax:
Practice Address - Street 1:305 N HEATHERWILDE BLVD BLDG D
Practice Address - Street 2:SUITE # 1A & 1B
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3757
Practice Address - Country:US
Practice Address - Phone:925-819-6834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist