Bhaktavathsala Reddy Dandolu, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

14614 Issued in NV

Practice address

1707 W Charleston Blvd
Suite 160
Las Vegas, NV 89102-2351

Phone

(702) 671-5150

Fax

(702) 384-6493

NPI assigned

Jul 12, 2007

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 names 1

• B. Reddy Dandolu Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Cooper Surgical Associates

  • Urology Physician
  • Cherry Hill, NJ
  • NPI 1083732143
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1376742163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD",
            "address_2": "SUITE 215",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022325",
            "telephone_number": "702-671-2395",
            "fax_number": "702-382-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD",
            "address_2": "SUITE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022351",
            "telephone_number": "702-671-5150",
            "fax_number": "702-384-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDOLU",
        "first_name": "BHAKTAVATHSALA",
        "middle_name": "REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA06622600",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "C51992",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NV",
            "license": "14614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "B.",
            "last_name": "DANDOLU",
            "middle_name": "REDDY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Charlotte Marie Dancy
• Delereese Dancy
• Lafrances Dancy
• Dandelion Behavioral Health Corp
• Dandelion Behavioral Health Services LLC
• Adena Lynn Dandridge
• Nephaterie Dandridge
• Courtney Dandy Fralick, LMFT, LCADC-INTERN
• Crystal Dandy
• Jason Danels

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.