Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Gangadhar Immanni, DDS

Individual provider General Practice Dentistry · NPI 1912285032

Dr. Gangadhar Immanni, DDS is a General Practice Dentistry in Portales, New Mexico. Licensed in New Mexico. Registered with an NPI since 2011.

Licensed in
NM
In the registry since
2011
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1515 W Fir
Portales, NM 88130
Phone: (575) 356-6695
Fax: (575) 356-5948
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DD3547 (NM)

Record details

NPI number1912285032
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJuly 22, 2011
Last updated in NPPESNovember 13, 2012

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