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General NPI Number Information
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NPI Number | 1356642516
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Entity Type | Individual
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Provider Name | ASHA KIRAN GUMMADI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 3260 N TOLTEC RD
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City | ELOY
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State | AZ
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Zip | 85131-9661
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Country | US
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Telephone | 520-466-3920
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Fax | 520-466-3921
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Provider Business Mailing Address
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Address Line | 255 S DOBSON RD STE M3
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City | CHANDLER
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State | AZ
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Zip | 85224-6231
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Country | US
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Telephone | 480-793-7354
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Fax | 480-771-8500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | D8527
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License Number State | AZ
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