Provider Demographics
NPI:1437414620
Name:VEERAM REDDY, RAVINDRANATH REDDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAVINDRANATH REDDY
Middle Name:
Last Name:VEERAM REDDY
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 1:5310 CARNABY ST
Mailing Address - Street 2:APT 335
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3193
Mailing Address - Country:US
Mailing Address - Phone:810-515-0445
Mailing Address - Fax:
Practice Address - Street 1:1012 E ENNIS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119
Practice Address - Country:US
Practice Address - Phone:972-875-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice