Sai Vineetha Duddu, DDS
Individual provider Active NPI Dentist · Webb City, MO
NPI 1942994652 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1942994652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2023020511 (MO)
- Practice address
- 501 S Madison St Ste P
Webb City, MO 64870-2426 - Phone
- (417) 392-6090
- NPI assigned
- Jun 6, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023020511 | MO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2023020511 | MO | Yes |
Addresses
Primary practice location
501 S Madison St Ste P
Webb City, MO 64870-2426
Mailing address
2040 Laquesta Drive
Neosho, MO 64850
Phone (417) 451-1566
Other practice location 1
2040 Laquesta Drive
Neosho, MO 64850
Phone (417) 451-1566
Other providers in Webb City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.