Ambica Reddy, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2023043787 Issued in MO

Practice address

530 S Maiden LN
Joplin, MO 64801-3084

Phone

(417) 782-0080

Fax

(417) 782-0096

NPI assigned

Jan 17, 2023

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 MO

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.

• Family Dental of Virginia, LLC

  • General Practice Dentistry
  • Hampton, VA
  • NPI 1689942377
  NPD (past)

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1346955119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 S MINNESOTA AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042238",
            "telephone_number": "267-496-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIDEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013084",
            "telephone_number": "417-782-0080",
            "fax_number": "417-782-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "AMBICA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2023043787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Reagen, DO
• Daniel Grant Reavis
• David Reavis
• Roxanne Carandang Recede
• Matthew Ty Reddick, DO
• Redings Mill Internal Care
• Spencer B Redmon
• Brian S Reed, PAC
• Brittani Alesha Reed, FNP-C
• Justin W Reed, D.O.

• General Practice Dentistry in Joplin, MO
• Providers in Joplin, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.