Srujani Reddy Gadusu, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042245 Issued in PA

Practice address

2091 N Collins Blvd # 100
Richardson, TX 75080-2636

Phone

(972) 644-3800

NPI assigned

Jun 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Diya Dental PLLC

  • General Practice Dentistry
  • Little Elm, TX
  • NPI 1215829148
  NPD Authorized official

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1417518457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 CRISTO LN",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750707377",
            "telephone_number": "713-714-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 N COLLINS BLVD # 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802636",
            "telephone_number": "972-644-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADUSU",
        "first_name": "SRUJANI REDDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35854",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Catherine Fusco, FNP-C
• G. Ray Hamby, D.D.S., M.S.D., Inc.
• Kenyon Owen Gaar, RD, LD
• Huda Gadid, FNP-BC
• Steven M Gadol, MD PA
• Richard J Gaeta, DPT
• Brandy Denise Gagnard Marcus, MOTR
• Garry Francis Gagnon, MD
• Madeline Rae Galey, MOT, OTR
• Kimberly Galindo

• General Practice Dentistry in Richardson, TX
• Providers in Richardson, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.