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General NPI Number Information
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NPI Number | 1699691634
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Entity Type | Individual
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Provider Name | SARANYA DEVATHA MALLAREDDY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 110 E SOUTH BOUNDARY ST
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City | PERRYSBURG
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State | OH
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Zip | 43551-2527
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Country | US
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Telephone | 419-792-1264
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 MULBERRY OAK LN
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City | GEORGETOWN
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State | TX
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Zip | 78628-3756
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Country | US
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Telephone | 437-989-4329
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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 | 30.028572
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License Number State | OH
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