Provider Demographics
NPI:1073016929
Name:ANKIREDDY, DEEPIKA (DDS)
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:ANKIREDDY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEEPIKA
Other - Middle Name:
Other - Last Name:ANKIREDDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DR
Mailing Address - Street 1:2001 S MEYERS RD APT 401
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-5272
Mailing Address - Country:US
Mailing Address - Phone:405-880-2684
Mailing Address - Fax:
Practice Address - Street 1:2801 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1989
Practice Address - Country:US
Practice Address - Phone:630-416-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0314971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice