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General NPI Number Information
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NPI Number | 1407380207
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Entity Type | Organization
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Legal Business Name | NIRUP REDDY AND BORTAY DEHNADI D.D.S, INC.
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 1507 PANAMA LN STE 102
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City | BAKERSFIELD
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State | CA
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Zip | 93307-5682
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Country | US
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Telephone | 661-398-5555
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Fax | 661-398-5510
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Provider Business Mailing Address
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Address Line | 1507 PANAMA LN STE 102
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City | BAKERSFIELD
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State | CA
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Zip | 93307-5682
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Country | US
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Telephone | 661-398-5555
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Fax | 661-398-5510
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Authorized Official
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Title or Position | DENTIST
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Name | NIRUP REDDY
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Credential | D.D.S
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Telephone | 661-398-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 50800
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License Number State | CA
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