Provider Demographics
NPI:1356625107
Name:SAMA, SWETHA REDDY (DMD)
Entity type:Individual
Prefix:DR
First Name:SWETHA
Middle Name:REDDY
Last Name:SAMA
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 1:2001 SOUTH MOPAC EXPRESSWAY
Mailing Address - Street 2:APT 2024
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:919-260-7209
Mailing Address - Fax:
Practice Address - Street 1:2525 W ANDERSON LN
Practice Address - Street 2:BUILDING 3, SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1180
Practice Address - Country:US
Practice Address - Phone:512-420-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice