Avanija Reddy

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9893 Issued in TN

Practice address

107 Bonnabrook Dr
Hermitage, TN 37076-1910

Phone

(615) 889-1654

NPI assigned

Aug 22, 2014

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: areddy413504@direct-ehr-ssmhc.com

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.

• Hermitage Pediatric Dentistry

  • Dental Clinic/Center
  • Hermitage, TN
  • NPI 1174852958
  NPD (past)

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1821498163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BONNABROOK DR",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BONNABROOK DR",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761910",
            "telephone_number": "615-889-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "AVANIJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "9893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ma. Monica N Puzon
• Richard W Quisling, M.D.
• Jennifer J Raleigh, RN
• Elizabeth Vance Randolph, M.D.
• Amber Michelle Reams, NP
• Kendall Redmond, PHARMD
• Caitlyn Reed
• Savannah Regensburger, M.S.
• Michael L Reid, MD
• Ronald C Rentuza, MD

• Pediatric Dentistry in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.