Provider Demographics
NPI:1376941443
Name:REDDY, VEENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VEENA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 STANTON CHRISTIANA RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2146
Mailing Address - Country:US
Mailing Address - Phone:302-998-0304
Mailing Address - Fax:302-998-0306
Practice Address - Street 1:537 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 211
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2146
Practice Address - Country:US
Practice Address - Phone:302-998-0304
Practice Address - Fax:302-998-0306
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE100012011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice