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General NPI Number Information
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NPI Number | 1548044233
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Entity Type | Individual
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Provider Name | SAJAN ANISH REDDY DMD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 17909 CACHET ISLE DR
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City | TAMPA
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State | FL
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Zip | 33647-2703
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Country | US
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Telephone | 813-325-0995
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Fax |
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Provider Business Mailing Address
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Address Line | 17909 CACHET ISLE DR
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City | TAMPA
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State | FL
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Zip | 33647-2703
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Country | US
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Telephone | 813-325-0995
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2024018993
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14012
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12348
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN31068
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD.10642
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN123322
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D.007291-C1
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License Number State | AL
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Taxonomy #8
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6001823-15
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License Number State | WI
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