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General NPI Number Information
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NPI Number | 1811620222
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Entity Type | Individual
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Provider Name | SRI NITYA REDDY REDDY INDURI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3365 PIEDMONT RD NE STE 1110
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City | ATLANTA
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State | GA
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Zip | 30305-1708
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Country | US
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Telephone | 404-382-8310
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Fax |
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Provider Business Mailing Address
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Address Line | 23 FERRY LANDING LN NW UNIT 2402
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City | ATLANTA
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State | GA
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Zip | 30305-1664
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Country | US
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Telephone | 425-503-3690
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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 | DN122801
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License Number State | GA
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