MEDICARE: DR. DEEPTHI KUNCHEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS041704	PA
2	122300000X	Dentist	34873	TX

General Provider Information

NPI Number	:	1033601802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPTHI KUNCHEY

Provider Business Mailing Address
First Line	:	2213 PADRON PL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-4429
Country	:	US
Telephone Number	:	610-864-0482
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 ORLANDO ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-4855
Country	:	US
Telephone Number	:	713-742-5020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	08/08/2020

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Directions to “ DR. DEEPTHI KUNCHEY ” Practice Location

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