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General NPI Number Information
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NPI Number | 1669656401
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Entity Type | Individual
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Provider Name | SWATHI R REDDY DDS
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Gender | Female
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 9010 LORTON STATION BLVD SUITE 260
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City | LORTON
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State | VA
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Zip | 22079-4792
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Country | US
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Telephone | 703-337-4414
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Fax | 703-337-4495
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Provider Business Mailing Address
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Address Line | 9010 LORTON STATION BLVD SUITE 260
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City | LORTON
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State | VA
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Zip | 22079-4792
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Country | US
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Telephone | 703-337-4414
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Fax | 703-337-4495
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 14283
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License Number State | MD
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