| Reddy Dental Group | |
|
4570 W El Segundo Blvd Hawthorne CA 90250-4318 | |
| (310) 973-1919 | |
| (310) 679-7777 |
| Full Name | Reddy Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 4570 W El Segundo Blvd, Hawthorne, California |
| Authorized Official Name and Position | Nirup Reddy (OWNER) |
| Authorized Official Contact | 3109731919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reddy Dental Group 251 W Harvard Blvd Santa Paula CA 93060-3213 Ph: (310) 973-1919 | Reddy Dental Group 4570 W El Segundo Blvd Hawthorne CA 90250-4318 Ph: (310) 973-1919 |
| NPI Number | 1487027843 |
|---|---|
| Provider Enumeration Date | 11/07/2015 |
| Last Update Date | 11/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487027843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 50800 (California) | Primary |
| 122300000X | Dentist | 56334 (California) | Secondary |
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