Provider Demographics
NPI:1043382781
Name:ANNAMAREDDY, SUNEETA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNEETA
Middle Name:
Last Name:ANNAMAREDDY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 E NIGHTINGALE LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-6849
Mailing Address - Country:US
Mailing Address - Phone:480-940-7746
Mailing Address - Fax:
Practice Address - Street 1:2711 S ALMA SCHOOL RD STE 10
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4022
Practice Address - Country:US
Practice Address - Phone:480-820-3755
Practice Address - Fax:480-820-0982
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice