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General NPI Number Information
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NPI Number | 1891081014
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Entity Type | Individual
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Provider Name | CHANUKYA REDDY DASARI MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 710 CORONADO CENTER DR STE 200
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City | HENDERSON
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State | NV
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Zip | 89052-4291
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Country | US
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Telephone | 702-602-6600
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Fax | 702-602-6800
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Provider Business Mailing Address
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Address Line | 10624 S EASTERN AVE STE A623
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City | HENDERSON
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State | NV
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Zip | 89052-2982
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Country | US
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Telephone | 702-602-6600
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Fax | 702-602-6800
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 16426
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License Number State | NV
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