Provider Demographics
NPI:1154686350
Name:DUGGIREDDY, HEMASUNDRA REDDY (DMD)
Entity Type:Individual
Prefix:
First Name:HEMASUNDRA
Middle Name:REDDY
Last Name:DUGGIREDDY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-1812
Mailing Address - Country:US
Mailing Address - Phone:978-249-8545
Mailing Address - Fax:978-249-4615
Practice Address - Street 1:38 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-1812
Practice Address - Country:US
Practice Address - Phone:978-249-8545
Practice Address - Fax:978-249-4615
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist