Provider Demographics
NPI:1407998016
Name:REDDI, TANU (DDS)
Entity Type:Individual
Prefix:DR
First Name:TANU
Middle Name:
Last Name:REDDI
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 1:1730 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 2P
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4905
Mailing Address - Country:US
Mailing Address - Phone:914-793-9393
Mailing Address - Fax:914-793-0713
Practice Address - Street 1:1730 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 2P
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4905
Practice Address - Country:US
Practice Address - Phone:914-793-9393
Practice Address - Fax:914-793-0713
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0409791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics