NPIMap

Organization Active NPI

Raju Reddy DDS,MD,Inc.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Redwood City, CA
National Provider Identifier
1447425392
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
OMS46 Issued in CA
Legal business name
RAJU REDDY DDS,MD,INC.
Practice address
11 Birch St
Suite 110
Redwood City, CA 94062-1480
Phone
(650) 387-6517
Fax
(650) 362-1980
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Raju Yeddula Reddy, DDS,MDNPI 1619072592
Title
President
Phone
(650) 387-6517

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X OMS46 CA Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X A80394 CA
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X GA 1293 CA

Addresses

Primary practice location

11 Birch St
Suite 110
Redwood City, CA 94062-1480

Mailing address

11 Birch St
Suite 110
Redwood City, CA 94062-1480
Phone (650) 387-6517

National Provider Directory

National Provider Directory

Locations

11 Birch St
Ste 110
Redwood City, CA 94062
Phone (650) 387-6517

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1447425392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BIRCH ST",
            "address_2": "SUITE 110",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621480",
            "telephone_number": "650-387-6517",
            "fax_number": "650-362-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BIRCH ST",
            "address_2": "SUITE 110",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621480",
            "telephone_number": "650-387-6517",
            "fax_number": "650-362-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJU REDDY DDS,MD,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "RAJU",
        "authorized_official_middle_name": "YEDDULA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-387-6517",
        "authorized_official_credential": "DDS,MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS46",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A80394",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "GA 1293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.