Lakshmi Mitreyi Gorugantula

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32505 Issued in TX

Practice address

13115 Josey LN
Farmers Branch, TX 75234-6350

Phone

(972) 243-7171

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1316366180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 BERRY RIDGE LN",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750340162",
            "telephone_number": "214-460-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 JOSEY LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752346350",
            "telephone_number": "972-243-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORUGANTULA",
        "first_name": "LAKSHMI MITREYI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "TX",
            "license": "32505",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "TX",
            "license": "32505",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christa Michelle Goff, FNP-C
• Julie Goff
• Lydia Golden
• Annie Gonzalez Yumar, RBT
• Leslie Gonzalez
• Betty M Gouge, PH.D.
• Tory Govan, M.S., BCBA, LBA
• Grace Adult Day Care, Inc.
• Karrington Graham
• Monique Grell, RBT

• General Practice Dentistry in Farmers Branch, TX
• Providers in Farmers Branch, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.