Healthcare Provider Details

I. General information

NPI: 1992968200
Provider Name (Legal Business Name): UDAYASENA REDDY DENDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: UDAYA SENA REDDY DENDI M.D.

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 LEBANON ST
MELROSE MA
02176-3225
US

IV. Provider business mailing address

14050 NW 14TH ST SUITE 190
SUNRISE FL
33323-2865
US

V. Phone/Fax

Practice location:
  • Phone: 781-979-3000
  • Fax:
Mailing address:
  • Phone: 800-424-3672
  • Fax: 954-377-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number249984
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2010025671
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number249984
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: