MEDICARE: REDDY DEHNADI REDDY DDS, 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1619811791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDDY DEHNADI REDDY DDS, INC.

Provider Business Mailing Address
First Line	:	3117 PANAMA LN STE D
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313-3781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 PANAMA LN STE D
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313-3781
Country	:	US
Telephone Number	:	323-898-4555
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AVESTA REDDY
Credential	:	DMD
Telephone Number	:	323-898-4555

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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