Provider Demographics
NPI:1699043422
Name:REDLA, VINEELA (BDS)
Entity Type:Individual
Prefix:DR
First Name:VINEELA
Middle Name:
Last Name:REDLA
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S BREIEL BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5152
Mailing Address - Country:US
Mailing Address - Phone:513-423-9239
Mailing Address - Fax:513-423-4188
Practice Address - Street 1:210 S BREIEL BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5152
Practice Address - Country:US
Practice Address - Phone:513-423-9239
Practice Address - Fax:513-423-4188
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058723-11223G0001X
OH30.0260371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice