Prashant Reddy, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23534 Issued in TX

Practice address

4020 W Park Blvd
Plano, TX 75093-3839

Phone

(972) 596-7474

Fax

(972) 596-8170

NPI assigned

Aug 22, 2005

Sex

Male

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 TX

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

Practice roles

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

• Oral & Maxillofacial Arts of Plano, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Plano, TX
  • NPI 1770716813
  NPD (past) Authorized official

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1174515563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 W PARK BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 W PARK BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933839",
            "telephone_number": "972-596-7474",
            "fax_number": "972-596-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "PRASHANT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sudama Reddi, M.D.
• Angela Marie Redding, FNP-C
• Arhaanth Dharam Reddy, M.D.
• Gautam Bhimidi Reddy, M.D.
• Gireesh Reddy, DPM
• Prashanth K Reddy, MD
• Praveen D Reddy, R.PH
• Renuka Kondala Reddy, MD
• Shreya Reddy, MD
• Redemption Dental Frisco PLLC

• Oral and Maxillofacial Surgery (Dentist) in Plano, TX
• Providers in Plano, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.