Provider Demographics
NPI:1437403912
Name:VEMIREDDY, HARICHANDANA (DMD)
Entity Type:Individual
Prefix:
First Name:HARICHANDANA
Middle Name:
Last Name:VEMIREDDY
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 1:401BOYD DR
Mailing Address - Street 2:#6112
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6352
Mailing Address - Country:US
Mailing Address - Phone:972-833-7006
Mailing Address - Fax:
Practice Address - Street 1:401 BOYD DR
Practice Address - Street 2:#6112
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6355
Practice Address - Country:US
Practice Address - Phone:972-833-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist