# DR. NAGASHREE BALUR PRAKASH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1811159247
- **Gender:** F
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 54839 | CA | — |
| 1223G0001X | General Practice Dentistry | DD3275 | NM | Yes |

## Other

- **Enumeration date:** 06/26/2008
- **Last updated:** 07/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 52932532 | — | NM |