MEDICARE: ANURADHA VADDINENI DMD

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	D12860	MN
2	1223G0001X	General Practice Dentistry	27886	TX

General Provider Information

NPI Number	:	1972817203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANURADHA VADDINENI DMD

Provider Business Mailing Address
First Line	:	6305 PRECINCT LINE ROAD
Second Line	:	SUITE #400
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180
Country	:	US
Telephone Number	:	817-663-0076
Fax Number	:	817-663-0081

Provider Business Practice Location Address
First Line	:	6305 PRECINCT LINE ROAD
Second Line	:	SUITE #400
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180
Country	:	US
Telephone Number	:	817-663-0076
Fax Number	:	817-663-0081

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

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	06/08/2021

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Directions to “ ANURADHA VADDINENI DMD” Practice Location

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