Keerthi Reddy Kamreddy, M.S IN PERIODONTOLOG

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401416692 Issued in VA

Practice address

9097 Atlee Station Rd Ste 120
Mechanicsville, VA 23116-2525

Phone

(804) 270-5214

NPI assigned

Sep 22, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kamreddy Dental Associates PLLC

  • Periodontics
  • Manassas, VA
  • NPI 1093693715
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569110400000",
    "number": "1114578192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22480 TERRA ROSA PL",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201487350",
            "telephone_number": "913-832-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9097 ATLEE STATION RD STE 120",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162525",
            "telephone_number": "804-270-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMREDDY",
        "first_name": "KEERTHI REDDY",
        "name_prefix": "Dr.",
        "credential": "M.S IN PERIODONTOLOG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-22",
        "last_updated": "2019-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401416692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard D Kahn, MD
• Rebecca Suzanne Kaiser, MD
• Swapna Gayathri Kallu, MD
• Valentina Kaminski, LPTA
• Brian Leonard Kaminsky, MD
• Gregory Kang, PHARMD
• Mark J Kapros, M.D.
• Jennifer Diane Karabin, NP
• Ray F. Keate, M.D.
• Adam Robert Keefer, M.D.

• Periodontics in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.