1831277003 NPI number — DR. SAVITHA REDDY DMD

Table of content: (NPI 1154367217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831277003 NPI number — DR. SAVITHA REDDY DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REDDY
Provider First Name:
SAVITHA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAMBAM
Provider Other First Name:
SAVITHA
Provider Other Middle Name:
REDDY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831277003
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 CARMAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST MEADOW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11554-1137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-794-3301
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
729 ELMONT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELMONT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11003-4035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-285-2000
Provider Business Practice Location Address Fax Number:
516-285-2000
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  046903-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01732732 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com