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Dr. Vijaya Lakshmi Bathina, DMD

Dentist, General Practice in Keller, TX. Individual provider (NPI-1).

NPI number1306194451
StatusActive
Last updated in NPPESJan 17, 2022

Details

NPI
1306194451
Entity type
Individual (NPI-1)
Name
Dr. Vijaya Lakshmi Bathina
Credential
DMD
Sex
Female
Sole proprietor
No
Enumeration date
Aug 21, 2012
Certification date
Jan 17, 2022
Last updated
Jan 17, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice29516TXYes
1223G0001X Dentist, General PracticeDN1856099MA
1223G0001X Dentist, General Practice019.029181IL

Practice location

794 Keller Pkwy Ste A
Keller, TX 76248-2490

Phone 817-431-1596

Mailing address

519 Hidden Meadow Dr
Keller, TX 76248-1229

Phone 806-420-9134

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