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General NPI Number Information
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NPI Number | 1073726006
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Entity Type | Organization
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Legal Business Name | J.V.REDDY, D.D.S,INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40 PENNY LN
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City | WATSONVILLE
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State | CA
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Zip | 95076-6008
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Country | US
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Telephone | 831-724-0245
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Fax | 831-724-0549
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Provider Business Mailing Address
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Address Line | 40 PENNY LN
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City | WATSONVILLE
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State | CA
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Zip | 95076-6008
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Country | US
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Telephone | 831-724-0245
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Fax | 831-724-0549
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. J V REDDY
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Credential | D.D.S
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Telephone | 831-724-0245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26511
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License Number State | CA
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