Provider Demographics
NPI:1609183524
Name:ADUSUMILLI, ANUPAMA VALLURU (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANUPAMA
Middle Name:VALLURU
Last Name:ADUSUMILLI
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 1:1001 S MEADOWS PKWY
Mailing Address - Street 2:APT#1828
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3865
Mailing Address - Country:US
Mailing Address - Phone:916-221-1732
Mailing Address - Fax:
Practice Address - Street 1:1715 KUENZLI ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1117
Practice Address - Country:US
Practice Address - Phone:775-334-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV60811223G0001X
TX280231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice