Provider Demographics
NPI:1609608025
Name:MAHAVADI, SNEHA (DDS)
Entity type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:
Last Name:MAHAVADI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 COUNTY ROAD 90 APT 327
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5114
Mailing Address - Country:US
Mailing Address - Phone:832-686-1312
Mailing Address - Fax:
Practice Address - Street 1:1708 N AMBURN RD STE A
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2489
Practice Address - Country:US
Practice Address - Phone:409-935-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX408991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice