MEDICARE: REDDY DENTAL INC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1174487458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDDY DENTAL INC

Provider Business Mailing Address
First Line	:	6751 1ST AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33707-1307
Country	:	US
Telephone Number	:	813-377-3339
Fax Number	:

Provider Business Practice Location Address
First Line	:	6751 1ST AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33707-1307
Country	:	US
Telephone Number	:	727-377-3339
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/DENTIST
Name	:	DR. SAJAN ANISH REDDY
Credential	:	DMD
Telephone Number	:	727-377-3339

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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