Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1811511470 Individual Practitioner Female Practitioner

Geeta Gyaneshwari Mandavilli

Dentist - General Practice • Longview, TX

Professional Overview & Biography Verified Profile Summary

Geeta Mandavilli is a registered healthcare professional specializing in Dentist - General Practice in Longview, TX. Practice services are available at 3080 N EASTMAN RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3080 N Eastman Rd

Longview, TX 756055174

Telephone 9036860086

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Longview, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
64 Specialists

Practicing in Longview, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-11-07
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 36840

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License LA 7054-PR

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.

Secondary Practice Locations

7251 Youree Dr

Shreveport, LA 711055104

Phone: 3344889669

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1457032476

Doctor of Dental Surgery

Dr. Sterling Dao , DMD

Dentist - General Practice

NPI 1740911452

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location November 07, 2021

Registered at 3080 N EASTMAN RD, LONGVIEW, TX 756055174 (Tel: 9036860086)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 07, 2021

Dentist (License #36840 in TX)

NPI Profile Active May 29, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location May 29, 2020

Registered at 7251 YOUREE DR, SHREVEPORT, LA 711055104 (Tel: 3344889669)

📍
Updated Business Mailing Address May 29, 2020

Registered at 301 COUNTY ROAD 207 APT 1110, ALVARADO, TX 760091450 (Tel: 3344889669)

👤
Provider Name / Credentials Updated May 29, 2020

Recorded as GEETA MANDAVILLI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2020

Dentist (License #7054-PR in LA)

🟢
Initial NPI Registration & Enumeration May 29, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811511470
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 29, 2020
Last Update: November 07, 2021
Sole Proprietor: Yes

Mailing Address

301 County Road 207 Apt 1110

Alvarado, TX 760091450

Phone: 3344889669

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.