Sunil Kumar Reddy Guddeti, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD4236 Issued in NM

Practice address

6330 Riverside Plaza LN NW Ste 165
Albuquerque, NM 87120

Phone

(571) 484-3008

Fax

(505) 639-4684

NPI assigned

Jun 27, 2013

Last updated

Jun 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1336589951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 LACUESTA CT NE",
            "city": "RIORANCHO",
            "state": "NM",
            "postal_code": "871246383",
            "telephone_number": "571-484-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 RIVERSIDE PLAZA LN NW STE 165",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87120",
            "telephone_number": "571-484-3008",
            "fax_number": "505-639-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDDETI",
        "first_name": "SUNIL KUMAR REDDY",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29647",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039583",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54501334",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guardian Flight LLC
• Guardian Recovery - Virtual Counseling LLC
• Guardian Wellness, LLC
• John Guarino, P.T.
• Prathyusha Gudapati, DO
• Bridget Guenther, M.S., CCC-SLP
• Jacquelynn Lopez Guerin
• Peter T Guerin, MD
• Erica Guerra
• Jessica Ann Guerra

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.