Healthcare Provider Details

I. General information

NPI: 1124594049
Provider Name (Legal Business Name): SHILPA REDDY ADMALA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16275 MONTEREY ST
MORGAN HILL CA
95037-5466
US

IV. Provider business mailing address

16275 MONTEREY ST
MORGAN HILL CA
95037-5466
US

V. Phone/Fax

Practice location:
  • Phone: 408-763-3008
  • Fax:
Mailing address:
  • Phone: 408-763-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number107988
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1858152
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: