Individual provider Active NPI

Manas Sai Kommareddi, DDS

  • General Practice Dentistry
  • Tulsa, OK
National Provider Identifier
1659164440
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8042 Issued in OK
Practice address
1302 S Garnett Rd
Tulsa, OK 74128-1825
Phone
(539) 217-0491
NPI assigned
May 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8042 OK Primary

Addresses

Primary practice location

1302 S Garnett Rd
Tulsa, OK 74128-1825

Mailing address

2219 E 11TH St Unit 408
Tulsa, OK 74104-3654
Phone (918) 640-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8042OKMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1659164440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 E 11TH ST UNIT 408",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741043654",
            "telephone_number": "918-640-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S GARNETT RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741281825",
            "telephone_number": "539-217-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMAREDDI",
        "first_name": "MANAS",
        "middle_name": "SAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "8042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; 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.