Provider Demographics
NPI:1992910517
Name:CHUKKAPALLI, NEEVA (DMD)
Entity type:Individual
Prefix:
First Name:NEEVA
Middle Name:
Last Name:CHUKKAPALLI
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 1:26735 US HWY 380 E
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227
Mailing Address - Country:US
Mailing Address - Phone:972-347-1090
Mailing Address - Fax:972-347-1021
Practice Address - Street 1:26735 US HWY 380 E
Practice Address - Street 2:SUITE 105
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227
Practice Address - Country:US
Practice Address - Phone:972-347-1090
Practice Address - Fax:972-347-1021
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice