Provider Demographics
NPI:1841588142
Name:ANNAPAREDDY, ANUPAMA (DDS)
Entity Type:Individual
Prefix:
First Name:ANUPAMA
Middle Name:
Last Name:ANNAPAREDDY
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 1:11900 HOBBY HORSE CT
Mailing Address - Street 2:APT # 324
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2989
Mailing Address - Country:US
Mailing Address - Phone:916-281-6080
Mailing Address - Fax:
Practice Address - Street 1:1100 LOWES BLVD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5491
Practice Address - Country:US
Practice Address - Phone:254-449-8163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice