NPIMap

Organization Active NPI

D Mahendra Mavalli PLLC

  • Pediatric Dentistry
  • Keller, TX
National Provider Identifier
1912629809
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
D MAHENDRA MAVALLI PLLC
Practice address
151 Ridge Point Pkwy Ste 100
Keller, TX 76248-8801
Phone
(817) 697-5166
NPI assigned
Sep 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Mahendra D Mavalli, PHDNPI 1558630251
Title
Pediatric Dentist
Phone
(469) 961-7082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

151 Ridge Point Pkwy Ste 100
Keller, TX 76248-8801

Mailing address

333 Beechwood LN
Coppell, TX 75019-5307
Phone (469) 961-7082

Other names 1

  • Hawk Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1912629809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BEECHWOOD LN",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195307",
            "telephone_number": "469-961-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 RIDGE POINT PKWY STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762488801",
            "telephone_number": "817-697-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D MAHENDRA MAVALLI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MAVALLI",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "469-961-7082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawk Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hawk Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.