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DR. GANGADHAR IMMANNI DDS
NPI 1912285032
Dentist - General Practice in Portales, NM

Active since July 22, 2011
1515 WEST FIR, PORTALES, NM 88130(575) 356-6695(575) 356-5948 Get Directions Write a Review

NPPES record last updated: November 13, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Gangadhar Immanni Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GANGADHAR IMMANNI DDS (NPI 1912285032) is an individual general practice provider in Portales, New Mexico, licensed in New Mexico (DD3547) and active in the NPI registry since July 2011.

NPPES Registry Identity

NPI1912285032
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. GANGADHAR IMMANNICredential: DDS
Location Address1515 WEST FIRPortales, NM 88130
Mailing Address1515 West Fir, Po Box 843Portales, NM 88130 · (575) 356-6695 · Fax (575) 356-5948
Phone(575) 356-6695
Fax(575) 356-5948
Sole ProprietorNo
Enumeration DateJuly 22, 2011
Last NPPES UpdateNovember 13, 2012
✔ NPI 1912285032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NM · DD3547
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1515 WEST FIR, Portales, NM 88130
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE ACEVEDO GONZALEZ MD
Internal Medicine
1515 WEST FIR
PORTALES, NM 88130
Roosevelt County (575) 356-6695
LINDSAY D CHRISTENSEN DMD
Dentist
1515 WEST FIR
PORTALES, NM 88130
Roosevelt County (505) 356-6695
JAMES FRANKLIN SMITH DDS
Dentist
1515 WEST FIR
PORTALES, NM 88130
Roosevelt County (505) 356-6695
MARTHA SLEMP THORSEN CNP
Nurse Practitioner (Family)
1515 WEST FIR
PORTALES, NM 88130
Roosevelt County (505) 356-6695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gangadhar Immanni's NPI number?

The NPI number for Gangadhar Immanni is 1912285032. It was assigned to this individual provider in the NPPES registry on July 22, 2011.

Where is Gangadhar Immanni located?

Gangadhar Immanni practices at 1515 West Fir, Portales, NM 88130. The listed phone number is (575) 356-6695.

What is Gangadhar Immanni's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Gangadhar Immanni accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Gangadhar Immanni as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gangadhar Immanni was last updated on November 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.