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General NPI Number Information
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NPI Number | 1659164440
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Entity Type | Individual
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Provider Name | MANAS SAI KOMMAREDDI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 1302 S GARNETT RD
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City | TULSA
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State | OK
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Zip | 74128-1825
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Country | US
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Telephone | 539-217-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 E 11TH ST UNIT 408
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City | TULSA
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State | OK
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Zip | 74104-3654
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Country | US
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Telephone | 918-640-1919
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8042
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License Number State | OK
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