Provider Demographics
NPI:1962159913
Name:VANGAPALLI, MUVVA RAO (DMD)
Entity type:Individual
Prefix:
First Name:MUVVA
Middle Name:RAO
Last Name:VANGAPALLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 MAPLE LEAF LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-0003
Mailing Address - Country:US
Mailing Address - Phone:781-315-1263
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST # F-2132
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program